THE  LIBRARY 

OF 

THE  UNIVERSITY 
OF  CALIFORNIA 

LOS  ANGELES 

GIFT  OF 

Dr.  Emil  Bogen 

1 


THE  WRITINGS   OF 
OLIVER  WENDELL   HOLMES 

IN  FOURTEEN  VOLUMES 
VOLUME  IX. 


9 


MEDICAL  ESSAYS 


1842  —  1882 


OLIVER  WENDELL  HOLMES 


BOSTON   AND    NEW  YORK 

HOUGHTON    MIFFLIN    COMPANY 

$fc  ttitaertfUe  press  Cambdbge 


COPYRIGHT,    lS6l,    1862,    1883,    1889,    l89°>   AND   '^Q1* 

BY   OLIVER  WENDELL  HOLMES 
COPYRIGHT,    1911,   BY   OLIVER  WENDELL   HOLMES 

ALL   RIGHTS   RESERVED 


tfiomedkal 
Library 


HM 

CONTENTS. 


^  PAG& 

L      HOM(EOPATHT  AND  ITS  KlNDRED  DELUSIONS          .  .        1 

II.     THE  CONTAGIOUSNESS  OF  PUERPERAL  FEVER    .        .      103 
^   TTT.    CURRENTS  AND  COUNTER-CURRENTS  IN  MEDICAL  SCI 
ENCE    173 

TV.    BORDER  LINES  OF  KNOWLEDGE  IN  SOME  PROVINCES  OP 

MEDICAL  SCIENCE 209 

V.    SCHOLASTIC  AND  BEDSIDE  TEACHING    ....  273 
VL    THE  MEDICAL  PROFESSION  IN  MASSACHUSETTS         .      312 

VII.    THE  YOUNG  PRACTITIONER 370 

VIII.    MEDICAL  LIBRARIES 396 

IX.    SOME  OF  MY  EARLY  TEACHERS       ....          420 


PKEFACE. 


THE  character  of  the  opposition  which  some  of  these 
papers  have  met  with  suggests  the  inference  that  they 
contain  really  important,  but  unwelcome  truths.  Neg 
atives  multiplied  into  each  other  change  their  sign 
and  become  positives.  Hostile  criticisms  meeting 
together  are  often  equivalent  to  praise,  and  the  square 
of  fault-finding  turns  out  to  be  the  same  thing  as 
eulogy. 

But  a  writer  has  rarely  so  many  enemies  as  it 
pleases  him  to  believe.  Self-love  leads  us  to  overrate 
the  numbers  of  our  negative  constituency.  The  larger 
portion  of  my  limited  circle  of  readers  must  be  quite 
indifferent  to,  if  not  ignorant  of,  the  adverse  opinions 
which  have  been  expressed  or  recorded  concerning 
any  of  these  Addresses  or  Essays  now  submitted  to 
their  own  judgment.  It  is  proper,  however,  to  in 
form  them,  that  some  of  the  positions  maintained  in 
these  pages  have  been  unsparingly  attacked,  with  va 
rious  degrees  of  ability,  scholarship,  and  good-breed 
ing.  The  tone  of  criticism  naturally  changes  with 
local  conditions  in  different  parts  of  a  country  ex 
tended  like  our  own,  so  that  it  is  one  of  the  most 
convenient  gauges  of  the  partial  movements  in  the 
direction  of  civilization.  It  is  satisfactory  to  add, 
that  the  views  assailed  have  also  been  unflinchingly 


VI  PREFACE. 

defended  by  unsought  champions,  among  the  ablest  oi 
whom  it  is  pleasant  to  mention,  at  this  moment  of  po 
litical  alienation,  the  Editor  of  the  Charleston  Medical 
Journal. 

"  Currents  and  Counter-Currents  "  was  written  and 
delivered  as  an  Oration,  a  florid  rhetorical  composi 
tion,  expressly  intended  to  secure  the  attention  of  an 
audience  not  easy  to  hold  as  listeners.  It  succeeded 
in  doing  this,  and  also  in  being  as  curiously  misunder 
stood  and  misrepresented  as  if  it  had  been  a  political 
harangue.  This  gave  it  more  local  notoriety  than  it 
might  otherwise  have  attained,  so  that,  as  I  learn,  one 
ingenious  person  made  use  of  its  title  as  an  advertise 
ment  to  a  production  of  his  own. 

The  commonest  mode  of  misrepresentation  was  this : 
qualified  propositions,  the  whole  meaning  of  which  de 
pended  on  the  qualifications,  were  stripped  of  these 
and  taken  as  absolute.  Thus,  the  attempt  to  establish 
&  presumption  against  giving  poisons  to  sick  persons 
was  considered  as  equivalent  to  condemning  the  use 
of  these  substances.  The  only  important  inference 
the  writer  has  been  able  to  draw  from  the  greater 
number  of  the  refutations  of  his  opinions  which  have 
been  kindly  sent  him,  is  that  the  preliminary  educa 
tion  of  the  Medical  Profession  is  not  always  what  it 
ought  to  be. 

One  concession  he  is  willing  to  make,  whatever 
sacrifice  of  pride  it  may  involve.  The  story  of  Mas- 
sasoit,  which  has  furnished  a  coral,  as  it  were,  for 
some  teething  critics,  when  subjected  to  a  powerful 
logical  analysis,  though  correct  in  its  essentials,  proves 
to  have  been  told  with  exceptionable  breadth  of  state 
ment,  and  therefore  (to  resume  the  metaphor)  has 
been  slightly  rounded  off  at  its  edges,  so  as  to  be 


PREFACE.  Vl 

smoother  for  any  who  may  wish  to  bite  upon  it  here 
after.  In  other  respects  the  Discourse  has  hardly  been 
touched.  It  is  only  an  individual's  expression,  in  his 
own  way,  of  opinions  entertained  by  hundreds  of  the 
Medical  Profession  in  every  civilized  country,  and  has 
nothing  in  it  which  on  revision  the  writer  sees  cause 
to  retract  or  modify.  The  superstitions  it  attacks  lie 
at  the  very  foundation  of  Homoeopathy,  and  of  almost 
every  form  of  medical  charlatanism.  Still  the  mere 
routinists  and  unthinking  artisans  in  most  callings 
dislike  whatever  shakes  the  dust  out  of  their  tradi 
tions,  and  it  may  be  unreasonable  to  expect  that 
Medicine  will  always  prove  an  exception  to  the  rule. 
One  half  the  opposition  which  the  numerical  system 
of  Louis  has  met  with,  as  applied  to  the  results  of 
treatment,  has  been  owing  to  the  fact  that  it  showed 
the  movements  of  disease  to  be  far  more  independent 
of  the  kind  of  practice  pursued  than  was  agreeable 
to  the  pride  of  those  whose  self-confidence  it  abated. 

The  statement,  that  medicines  are  more  sparingly 
used  in  physicians'  families  than  in  most  others,  ad 
mits  of  a  very  natural  explanation,  without  putting  a 
harsh  construction  upon  it,  which  it  was  not  intended 
to  admit.  Outside  pressure  is  less  felt  in  the  physi 
cian's  own  household ;  that  is  all.  If  this  does  not 
sometimes  influence  him  to  give  medicine,  or  what 
seems  to  be  medicine,  when  among  those  who  have 
more  confidence  in  drugging  than  his  own  family 
commonly  has,  the  learned  Professor  Dunglison  is 
hereby  requested  to  apologize  for  his  definition  of  the 
word  Placebo,  or  to  expunge  it  from  his  Medical 
Dictionary. 

One  thing  is  certain.  A  loud  outcry  on  a  slight 
touch  reveals  the  weak  spot  in  a  profession,  as  well  as 


Vlll  PREFACE. 

in  a  patient.  It  is  a  doubtful  policy  to  oppose  the 
freest  speech  in  those  of  our  own  number  who  are  try 
ing  to  show  us  where  they  honestly  believe  our  weak 
ness  lies.  Vast  as  are  the  advances  of  our  Science 
and  Art,  may  it  not  possibly  prove  on  examination 
that  we  retain  other  old  barbarisms  beside  the  use  of 
the  astrological  sign  of  Jupiter,  with  which  we  en 
deavor  to  insure  good  luck  to  our  prescriptions  ?  Is 
it  the  act  of  a  friend  or  a  foe  to  try  to  point  them  out 
to  our  brethren  when  asked  to  address  them,  and  is  the 
speaker  to  subdue  the  constitutional  habit  of  his  style 
to  a  given  standard,  under  penalty  of  giving  offence 
to  a  grave  assembly  ? 

"  Homoeopathy  and  its  Kindred  Delusions "  was 
published  nearly  twenty  years  ago,  and  has  been  long 
out  of  print,  so  that  the  author  tried  in  vain  to  procure 
a  copy  until  the  kindness  of  a  friend  supplied  him 
with  the  only  one  he  has  had  for  years.  A  foolish 
story  reached  his  ears  that  he  was  attempting  to  buy 
up  stray  copies  for  the  sake  of  suppressing  it.  This 
edition  was  in  the  press  at  that  very  time. 

Many  of  the  arguments  contained  in  the  Lectures 
have  lost  whatever  novelty  they  may  have  possessed. 
All  its  predictions  have  been  submitted  to  the  formi 
dable  test  of  time.  They  appear  to  have  stood  it,  so 
far,  about  as  well  as  most  uninspired  prophecies ;  in 
deed,  some  of  them  require  much  less  accommodation 
than  certain  grave  commentators  employ  in  their  read 
ings  of  the  ancient  Prophets. 

If  some  statistics  recently  published1  are  correct, 
Homoeopathy  has  made  very  slow  progress  in  Europe. 

1  Medical  Investigator.  Devoted  to  the  Advancement  of  the 
Homoepathic  System  of  Medicine.  Chicago,  January  1,  1861. 


PREFACE.  is 

In  all  England,  as  it  appears,  there  are  hardly  a  fifth 
more  Homoeopathic  practitioners  than  there  are  stu 
dents  attending  Lectures  at  the  Massachusetts  Medi 
cal  College  at  the  present  time.  In  America  it  has 
undoubtedly  proved  more  popular  and  lucrative,  yet 
how  loose  a  hold  it  has  on  the  public  confidence  is 
shown  by  the  fact  that,  when  a  specially  valued  life, 
which  has  been  played  with  by  one  of  its  agents,  is 
seriously  threatened,  the  first  thing  we  expect  to  hear 
is  that  a  regular  practitioner  is  by  the  patient's  bed, 
and  the  Homoeopathic  counsellor  overruled  or  dis 
carded.  Again,  how  many  of  the  ardent  and  capri 
cious  persons  who  embraced  Homoeopathy  have  run 
the  whole  round  of  pretentious  novelties ;  —  have 
been  boarded  at  water-cure  establishments,  closeted 
with  uterine  and  other  specialists,  and  finally  wan 
dered  over  seas  to  put  themselves  in  charge  of  foreign 
celebrities,  who  dosed  them  as  lustily  as  they  were  ever 
dosed  before  they  took  to  globules  !  It  will  surprise 
many  to  learn  to  what  a  shadow  of  a  shade  Homoeop 
athy  has  dwindled  in  the  hands  of  many  of  its  noted 
practitioners.  The  itch-doctrine  is  treated  with  con 
tempt.  Infinitesimal  doses  are  replaced  by  full  ones 
whenever  the  fancy-practitioner  chooses.  Good  Ho 
moeopathic  reasons  can  be  found  for  employing  any 
thing  that  anybody  wants  to  employ.  Homoeopathy 
is  now  merely  a  name,  an  unproved  theory,  and  a  box 
of  pellets  pretending  to  be  specifics,  which,  as  all  of 
us  know,  fail  ignominiously  in  those  cases  where  we 
would  thankfully  sacrifice  all  our  prejudices  and  give 
the  world  to  have  them  true  to  their  promises. 

Homoeopathy  has  not  died  out  so  rapidly  as  Tracto- 
ration.  Perhaps  it  was  well  that  it  should  not,  for  it 
has  taught  us  a  lesson  of  the  healing  faculty  of  Na- 


X  PREFACE. 

ture  which  was  needed,  and  for  which  many  of  us 
have  made  proper  acknowledgments.  But  it  probably 
does  more  harm  than  good  to  medical  science  at  the 
present  time,  by  keeping  up  the  delusion  of  treating 
everything  by  specifics,  —  the  old  barbarous  notion 
that  sick  people  should  feed  on  poisons,1  against  which 
a  part  of  the  Discourse  at  the  beginning  of  this  volume 
is  directed. 

The  infinitesimal  globules  have  not  become  a  curi 
osity  as  yet,  like  Perkins's  Tractors.  But  time  is  a 
very  elastic  element  in  Geology  and  Prophecy.  If 
Daniel's  seventy  weeks  mean  four  hundred  and  ninety 
years,  as  the  learned  Prideaux  and  others  have  set 
tled  it  that  they  do,  the  "  not  many  years  "  of  my  pre^ 
diction  may  be  stretched  out  a  generation  or  two  be 
yond  our  time,  if  necessary,  when  the  prophecy  will 
no  doubt  prove  true. 

It  might  be  fitting  to  add  a  few  words  with  regard 
to  the  Essay  on  the  Contagiousness  of  Puerperal  Fe 
ver.  But  the  whole  question  I  consider  to  be  now 
transferred  from  the  domain  of  medical  inquiry  to 
the  consideration  of  Life  Insurance  agencies  and 
Grand  Juries.  For  the  justification  of  this  somewhat 
sharply  accented  language  I  must  refer  the  reader  to 
the  paper  itself  for  details  which  I  regret  to  have  been 
forced  to  place  on  permanent  record. 

BOSTON,  January,  1861. 

1  Lachesis,  arrow-poison,  obtained   from    a    serpent   (Pulte).    * 
Crotalus  horridus,  rattlesnake's  venom  (Neidhard).     The  less 
dangerous  Pediculus  capitis  is  the  favorite  remedy  of  Dr.  Mure, 
the  English  "  Apostle  of  Homoeopathy."  These  are  examples  of 
the  retrograde  current  setting  towards  barbarism. 


A  SECOND  PREFACE. 


THESE  Lectures  and  Essays  are  arranged  in  the 
order  corresponding  to  the  date  of  their  delivery  or 
publication.  They  must,  of  course,  be  read  with  a 
constant  reference  to  these  dates,  by  such  as  care  to 
read  them.  I  have  not  attempted  to  modernize  their 
aspect  or  character  in  presenting  them,  in  this  some 
what  altered  connection,  to  the  public.  Several  of 
them  were  contained  in  a  former  volume  which  re 
ceived  its  name  from  the  Address  called  "  Currents 
and  Counter-Currents."  Some  of  those  contained  in 
the  former  volume  have  been  replaced  by  others.  The 
Essay  called  "  Mechanism  of  Vital  Actions  "  has  been 
transferred  to  a  distinct  collection  of  Miscellaneous 
Essays,  forming  a  separate  volume. 

I  had  some  intention  of  including  with  these  papers 
an  Essay  on  Intermittent  Fever  in  New  England, 
which  received  one  of  the  Boylston  prizes  in  1837,  and 
was  published  in  the  following  year.  But  as  this  was 
upon  a  subject  of  local  interest,  chiefly,  and  would 
have  taken  up  a  good  deal  of  room,  I  thought  it  best 
to  leave  it  out,  trusting  that  the  stray  copies  to  be  met 
with  in  musty  book-shops  would  sufficiently  supply  the 
not  very  extensive  or  urgent  demand  for  a  paper  al 
most  half  a  century  old. 

Some  of  these  papers  created  a  little  stir  when  they 


Ml  A   SECOND   PREFACE. 

first  fell  from  the  press  into  the  pool  of  public  con« 
sciousness.  They  will  slide  in  very  quietly  now  in 
this  new  edition,  and  find  out  for  themselves  whether 
the  waters  are  those  of  Lethe,  or  whether  they  are 
to  live  for  a  time  as  not  wholly  unvalued  reminis 
cences 

March  21,  188a 


PREFACE  TO  THE  NEW  EDITION. 


THESE  Essays  are  old  enough  now  to  go  alone  with> 
out  staff  or  crutch  in  the  shape  of  Prefaces.  A  very 
few  words  may  be  a  convenience  to  the  reader  who 
takes  up  the  book  and  wishes  to  know  what  he  is  likely 
to  find  in  it. 

HOMOEOPATHY  AND  ITS   KINDRED   DELUSIONS. 

Homeopathy  has  proved  lucrative,  and  so  long  as 
it  continues  to  be  so  will  surely  exist,  —  as  surely  as 
astrology,  palmistry,  and  other  methods  of  getting  a 
living  out  of  the  weakness  and  credulity  of  mankind 
and  womankind.  Though  it  has  no  pretensions  to  be 
considered  as  belonging  among  the  sciences,  it  may 
be  looked  upon  by  a  scientific  man  as  a  curious  object 
of  study  among  the  vagaries  of  the  human  mind.  Its 
influence  for  good  or  the  contrary  may  be  made  a 
matter  of  calm  investigation.  I  have  studied  it  in 
the  Essay  before  the  reader,  under  the  aspect  of  an 
extravagant  and  purely  imaginative  creation  of  its 
founder.  Since  that  first  essay  was  written,  nearly 
half  a  century  ago,  we  have  all  had  a  chance  to  wit 
ness  its  practical  working.  Two  opposite  inferences 
may  be  drawn  from  its  doctrines  and  practice.  The 
first  is  that  which  is  accepted  by  its  disciples.  This 
is  that  all  diseases  are  "cured"  by  drugs.  The  op« 


PREFACE  TO   THE  NEW  EDITION. 

posite  conclusion  is  drawn  by  a  much  larger  number 
of  persons.  As  they  see  that  patients  are  very  com 
monly  getting  well  under  treatment  by  infinitesimal 
drugging,  which  they  consider  equivalent  to  no  medi 
cation  at  all,  they  come  to  disbelieve  in  every  form 
of  drugging  and  put  their  whole  trust  in  "nature." 
Thus  experience, 

"  From  seeming  evil  still  educing  good," 

has  shown  that  the  dealers  in  this  preposterous  system 
of  pseudo-therapeutics  have  cooperated  with  the  wiser 
class  of  practitioners  in  breaking  up  the  system  of 
over-dosing  and  over-drugging  which  has  been  one  of 
the  standing  reproaches  of  medical  practice.  While 
keeping  up  the  miserable  delusion  that  diseases  were 
all  to  be  "cured"  by  drugging,  Homoeopathy  has  been 
unintentionally  showing  that  they  would  very  gener 
ally  get  well  without  any  drugging  at  all.  In  the 
mean  time  the  newer  doctrines  of  the  "  mind  cure," 
the  "faith  cure,"  and  the  rest  are  encroaching  on  the 
territory  so  long  monopolized  by  that  most  ingenious 
of  the  pseudo-sciences.  It  would  not  be  surprising  if 
its  whole  ground  should  be  taken  possession  of  by 
these  new  claimants  with  their  flattering  appeals  to 
the  imaginative  class  of  persons  open  to  such  attacks. 
Similia  similibus  may  prove  fatally  true  for  once,  if 
Homoeopathy  is  killed  out  by  its  new-born  rivals. 

It  takes  a  very  moderate  amount  of  erudition  to 
unearth  a  charlatan  like  the  supposed  father  of  the 
infinitesimal  dosing  system.  The  real  inventor  of 
that  specious  trickery  was  an  Irishman  by  the  name 
of  Butler.  The  whole  story  is  to  be  found  in  the 
"Ortus  Medicinse"of  Van  Helmont.  I  have  given 
some  account  of  his  chapter  "Butler"  in  different 


PREFACE  TO    THE  NEW   EDITION.  XV 

articles,  but  I  would  refer  the  students  of  our  Homoeo 
pathic  educational  institutions  to  the  original,  which 
they  will  find  very  interesting  and  curious. 

«,•;.-.  CURRENTS   AND  COUNTER-CURRENTS. 

My  attack  on  over-drugging  brought  out  some  hos 
tile  comments  and  treatment.  Thirty  years  ago  I  ex 
pressed  myself  with  more  vivacity  than  I  should  show 
if  I  were  writing  on  the  same  subjects  to-day.  Some 
of  my  more  lively  remarks  called  out  very  sharp  an 
imadversion.  Thus  my  illustration  of  prevention  as 
often  better  than  treatment  in  the  mother's  words  to 
her  child  which  had  got  a  poisonous  berry  in  its 
mouth,  —  "  Spit  it  out !  "  gave  mortal  offence  to  a 
well-known  New  York  practitioner  and  writer,  who 
advised  the  Massachusetts  Medical  Society  to  spit  out 
the  offending  speaker.  Worse  than  this  was  my 
statement  of  my  belief  that  if  a  ship-load  of  miscella 
neous  drugs,  with  certain  very  important  exceptions, 
—  drugs,  many  of  which  were  then  often  given  need 
lessly  and  in  excess,  as  then  used  "  could  be  sunk  to 
the  bottom  of  the  sea,  it  would  be  all  the  better  for 
mankind  and  all  the  worse  for  the  fishes."  This  was 
too  bad.  The  sentence  was  misquoted,  quoted  without 
its  qualifying  conditions,  and  frightened  some  of  my 
worthy  professional  brethren  as  much  as  if  I  had  told 
them  to  throw  all  physic  to  the  dogs.  But  for  the  epi 
grammatic  sting  the  sentiment  would  have  been  unno 
ticed  as  a  harmless  overstatement  at  the  very  worst. 

Since  this  lecture  was  delivered  a  great  and,  as  I 
think,  beneficial  change  has  taken  place  in  the  practice 
of  medicine.  The  habit  of  the  English  "general 
practitioner  "  of  making  his  profit  out  of  the  pills  and 
potions  he  administered  was  ruinous  to  professional 


XVI  PREFACE  TO   THE  NEW  EDITION. 

advancement  and  the  dignity  of  the  physician.  When 
a  half -starving  medical  man  felt  that  he  must  give  his 
patient  draughts  and  boluses  for  which  he  could  charge 
him,  he  was  in  a  pitiable  position  and  too  likely  to 
persuade  himself  that  his  drugs  were  useful  to  his  pa 
tient  because  they  were  profitable  to  him.  This  prac 
tice  has  prevailed  a  good  deal  in  America,  and  was 
doubtless  the  source  in  some  measure  of  the  errors  I 
combated. 

THE  CONTAGIOUSNESS  OP  PUERPERAL  FEVER. 

This  Essay  was  read  before  a  small  Association 
called  "The  Society  for  Medical  Improvement,"  and 
published  in  a  Medical  Journal  which  lasted  but  a 
single  year.  It  naturally  attracted  less  attention  than 
it  would  have  done  if  published  in  such  a  periodical  as 
the  "American  Journal  of  Medical  Sciences."  Still 
it  had  its  effect,  as  I  have  every  reason  to  believe.  I 
cannot  doubt  that  it  has  saved  the  lives  of  many  young 
mothers  by  calling  attention  to  the  existence  and  prop 
agation  of  "Puerperal  Fever  as  a  Private  Pestilence," 
and  laying  down  rules  for  taking  the  necessary  pre 
cautions  against  it.  The  case  has  long  been  decided 
in  favor  of  the  views  I  advocated,  but  at  the  time 
when  I  wrote  two  of  the  most  celebrated  professors  of 
Obstetrics  in  this  country  opposed  my  conclusions  with 
all  the  weight  of  their  experience  and  position. 

This  paper  was  written  in  a  great  heat  and  with 
passionate  indignation.  If  I  touched  it  at  all  I  might 
trim  its  rhetorical  exuberance,  but  I  prefer  to  leave  it 
all  its  original  strength  of  expression.  I  could  not,  if 
I  had  tried,  have  disguised  the  feelings  with  which 
I  regarded  the  attempt  to  put  out  of  sight  the  fright 
ful  facts  which  I  brought  forward  and  the  necessary 


PREFACE  TO   THE  NEW  EDITION.  XV11 

conclusions  to  which  they  led.  Of  course  the  whole 
matter  has  been  looked  at  in  a  new  point  of  view  since 
the  microbe  as  a  vehicle  of  contagion  has  been  brought 
into  light,  and  explained  the  mechanism  of  that  which 
was  plain  enough  as  a  fact  to  all  who  were  not  blind 
or  who  did  not  shut  their  eyes. 

o.  w.  H. 

BEVERLY  FABMS,  MASS.,  August  3,  189L 


MEDICAL  ESSAYS. 


HOM(EOPATHT  AND  ITS   KINDRED   DELUSIONS." 

Kairvov  ffKias  wap. 

[WHEN  a  physician  attempts  to  convince  a  person,  who  has  fallen  into 
the  Homoeopathic  delusion,  of  the  emptiness  of  its  pretensions,  he  is  often 
answered  by  a  statement  of  cases  in  which  its  practitioners  are  thought  to 
have  effected  wonderful  cures.  The  main  object  of  the  first  of  these  Lec 
tures  is  to  show,  by  abundant  facts,  that  such  statements,  made  by  persons 
unacquainted  with  the  fluctuations  of  disease  and  the  fallacies  of  observa 
tion,  are  to  be  considered  in  general  as  of  little  or  no  value  in  establishing 
the  truth  of  a  medical  doctrine  or  the  utility  of  a  method  of  practice. 

Those  kind  friends  who  suggest  to  a  person  suffering  from  a  tedious 
complaint,  that  he  "Had  better  try  Homoeopathy,"  are  apt  to  enforce 
their  suggestion  by  adding,  that  "at  any  rate  it  can  do  no  harm."  This 
may  or  may  not  be  true  as  regards  the  individual.  But  it  always  does  very 
great  harm  to  the  community  to  encourage  ignorance,  error,  or  deception 
in  a  profession  which  deals  with  the  life  and  health  of  our  fellow-creatures. 
Whether  or  not  those  who  countenance  Homoeopathy  are  guilty  of  this 
injustice  towards  others,  the  second  of  these  Lectures  may  afford  them 
some  means  of  determining. 

To  deny  that  good  effects  may  happen  from  the  observance  of  diet  and 
regimen  when  prescribed  by  Homoeopathists  as  well  as  by  others,  would 
be  very  unfair  to  them.  But  to  suppose  that  men  with  minds  so  consti 
tuted  as  to  accept  such  statements  and  embrace  such  doctrines  as  make  up 
the  so-called  science  of  Homeopathy  are  more  competent  than  others  to 
regulate  the  circumstances  which  influence  the  human  body  in  health  and 
disease,  would  be  judging  very  harshly  the  average  capacity  of  ordinary 
practitioners. 

To  deny  that  some  patients  may  have  been  actually  benefited  through 
the  influence  exerted  upon  their  imaginations,  would  be  to  refuse  to  Ho 
moeopathy  what  all  are  willing  to  concede  to  every  one  of  those  numerous 
modes  of  practice  known  to  all  intelligent  persons"  by  an  opprobrious  title. 

o  Two  lectures  delivered  before  the  Boston  Society  for  the  Diffusion  of  Useful 
Knowledge.  1842. 


2  MEDICAL  ESSAYS. 

So  long  as  the  body  is  affected  through  the  mind,  no  audacious  device, 
even  of  the  most  manifestly  dishonest  character,  can  fail  of  producing 
occasional  good  to  those  who  yield  it  an  implicit  or  even  a  partial  faith. 
The  argument  founded  on  this  occasional  good  would  be  as  applicable  in 
justifying  the  counterfeiter  and  giving  circulation  to  his  base  coin,  on  tha 
ground  that  a  spurious  dollar  had  often  relieved  a  poor  man's  necessities. 

Homoeopathy  has  come  before  our  public  at  a  period  when  the  growing 
spirit  of  eclecticism  has  prepared  many  ingenious  and  honest  minds  to  listen 
to  all  new  doctrines  with  a  candor  liable  to  degenerate  into  weakness.  It 
is  not  impossible  that  the  pretended  evolution  of  great  and  mysterious  vir 
tues  from  infinitely  attenuated  atoms  may  have  enticed  a  few  over-refining 
philosophers,  who  have  slid  into  a  vague  belief  that  matter  subdivided 
grows  less  material,  and  approaches  nearer  to  a  spiritual  nature  as  it  re 
quires  a  more  powerful  microscope  for  its  detection. 

However  this  may  be,  some  persons  seem  disposed  to  take  the  ground  of 
Menzel,  that  the  Laity  must  pass  formal  judgment  between  the  Physician 
and  the  Homoeopathist,  as  it  once  did  between  Luther  and  the  Romanists. 
The  practitioner  and  the  scholar  must  not,  therefore,  smile  at  the  amount  of 
time  and  labor  expended  in  these  Lectures  upon  this  shadowy  system ; 
which,  in  the  calm  and  serious  judgment  of  many  of  the  wisest  members 
of  the  medical  profession,  is  not  entitled  by  anything  it  has  ever  said  or 
done  to  the  notoriety  of  a  public  rebuke,  still  less  to  the  honors  of  critical 
martyrdom.] 


I  HAVE  selected  four  topics  for  this  lecture,  the  first 
three  of  which  I  shall  touch  but  slightly,  the  last  more 
fully.  They  are 

1.  The  Royal  cure  of  the  King's  Evil,  or  Scrofula. 

2.  The  Weapon  Ointment,  and  its  twin  absurdity, 
the  Sympathetic  Powder. 

3.  The  Tar-water  mania  of  Bishop  Berkeley. 

4.  The  History  of  the  Metallic  Tractors,  or  Per- 
kinism. 

The  first  two  illustrate  the  ease  with  which  numer 
ous  facts  are  accumulated  to  prove  the  most  fanciful 
and  senseless  extravagances. 

The  third  exhibits  the  entire  insufficiency  of  exalted 
wisdom,  immaculate  honesty,  and  vast  general  acquire 
ments  to  make  a  good  physician  of  a  great  bishop. 

The  fourth  shows  us  the  intimate  machinery  of  an 


HOMOEOPATHY   AND   ITS   KINDRED   DELUSIONS.      3 

extinct  delusion,  which  flourished  only  forty  years  ago ; 
drawn  in  all  its  details,  as  being  a  rich  and  compara 
tively  recent  illustration  of  the  pretensions,  the  argu 
ments,  the  patronage,  by  means  of  which  windy  errors 
have  long  been,  and  will  long  continue  to  be,  swollen 
into  transient  consequence.  All  display  in  superflu 
ous  abundance  the  boundless  credulity  and  excitability 
of  mankind  upon  subjects  connected  with  medicine. 


From  the  time  of  Edward  the  Confessor  to  Queen 
Anne,  the  monarchs  of  England  were  in  the  habit  of 
touching  those  who  were  brought  to  them  suffering 
with  the  scrofula,  for  the  cure  of  that  distemper. 
William  the  Third  had  good  sense  enough  to  discon 
tinue  the  practice,  but  Anne  resumed  it,  and,  among 
her  other  patients,  performed  the  royal  operation  upon 
a  child,  who,  in  spite  of  his  disease,  grew  up  at  last 
into  Samuel  Johnson.  After  laying  his  hand  upon 
the  sufferers,  it  was  customary  for  the  monarch  to 
hang  a  gold  piece  around  the  neck  of  each  patient. 
Very  strict  precautions  were  adopted  to  prevent  those 
ffho  thought  more  of  the  golden  angel  hung  round  the 
neck  by  a  white  ribbon,  than  of  relief  of  their  bodily 
infirmities,  from  making  too  many  calls,  as  they  some 
times  attempted  to  do.  "  According  to  the  statement 
of  the  advocates  and  contemporaries  of  this  remedy, 
none  ever  failed  of  receiving  benefit  unless  their  little 
faith  and  credulity  starved  their  merits.  Some  are 
said  to  have  been  cured  immediately  on  the  very  touch, 
others  did  not  so  easily  get  rid  of  their  swellings,  until 
they  were  touched  a  second  time.  Several  cases  are 
related,  of  persons  who  had  been  blind  for  several 
weeks,  and  months,  and  obliged  even  to  be  led  to 


4  MEDICAL   ESSAYS. 

Whitehall,  yet  recovered  their  sight  immediately  upon 
being  touched,  so  as  to  walk  away  without  any  guide."  a 
So  widely,  at  one  period,  was  the  belief  diffused, 
that,  in  the  course  of  twelve  years,  nearly  a  hundred 
thousand  persons  were  touched  by  Charles  the  Sec 
ond.  Catholic  divines,  in  disputes  upon  the  ortho 
doxy  of  their  church,  did  not  deny  that  the  power 
had  descended  to  protestant  princes ;  —  Dr.  Harps- 
field,  in  his  "  Ecclesiastical  History  of  England,"  ad 
mitted  it,  and  in  Wiseman's  words,  "  when  Bishop 
Tooker  would  make  use  of  this  Argument  to  prove 
the  Truth  of  our  Church,  Smitheus  doth  not  there 
upon  go  about  to  deny  the  Matter  of  fact ;  nay,  both 
he  and  Cope  acknowledge  it."  "  I  my  self,"  says 
Wiseman,  the  best  English  surgical  writer  of  his  day, 
—  "I  my  self  have  been  a  frequent  Eye-witness  of 
many  hundred  of  Cures  performed  by  his  Majesties 
Touch  alone,  without  any  assistance  of  Chirurgery ; 
and  those,  many  of  them  such  as  had  tired  out  the 
endeavours  of  able  Chirurgeons  before  they  came 
hither.  It  were  endless  to  recite  what  I  myself  have 
seen,  and  what  I  have  received  acknowledgments  of 
by  Letter,  not  only  from  the  severall  parts  of  this  Na 
tion,  but  also  from  Ireland,  Scotland,  Jersey,  Garn- 
sey.  It  is  needless  also  to  remember  what  Miracles 
of  this  nature  were  performed  by  the  very  Bloud  of 
his  late  Majesty  of  Blessed  memory,  after  whose  dec 
ollation  by  the  inhuman  Barbarity  of  the  Regicides, 
the  reliques  of  that  were  gathered  on  Chips  and  in 
Handkerchieffs  by  the  pious  Devotes,  who  could  not 
but  think  so  great  a  suffering  in  so  honourable  and 
pious  a  Cause,  would  be  attended  by  an  extraordi 
nary  assistance  of  God,  and  some  more  then  ordinary 
a  Edinburgh  Medical  and  Surgical  Journal,  vol.  iii.  p.  103. 


HOMOEOPATHY   AND   ITS   KINDRED   DELUSIONS.      5 

miracle:  nor  did  their  Faith  deceive  them  in  this 
there  point,  being  so  many  hundred  that  found  the 
benefit  of  it."  a 

Obstinate  and  incredulous  men,  as  he  tells  us,  ac 
counted  for  these  cures  in  three  ways  :  by  the  journey 
and  change  of  air  the  patients  obtained  in  coming  to 
London ;  by  the  influence  of  imagination ;  and  the 
wearing  of  gold. 

To  these  objections  he  answers,  —  1st.  That  many 
of  those  cured  were  inhabitants  of  the  city.  2d.  That 
the  subjects  of  treatment  were  frequently  infants. 
3d.  That  sometimes  silver  was  given,  and  sometimes 
nothing,  yet  the  patients  were  cured. 

A  superstition  resembling  this  probably  exists  at 
the  present  tune  in  some  ignorant  districts  of  Eng 
land  and  this  country.  A  writer  in  a  Medical  Jour 
nal  in  the  year  1807,  speaks  of  a  farmer  in  Devon 
shire,  who,  being  a  ninth  son  of  a  ninth  son,  is 
thought  endowed  with  healing  powers  like  those  of 
ancient  royalty,  —  and  who  is  accustomed  one  day 
in  every  week  to  strike  for  the  evil. 

I  remember  that  one  of  my  schoolmates  told  me, 
when  a  boy,  of  a  seventh  son  of  a  seventh  son,  some 
where  in  Essex  County,  who  touched  for  the  scrofula, 
and  who  used  to  hang  a  silver  fourpence  halfpenny 
about  the  neck  of  those  who  came  to  him,  which 
fourpence  halfpenny  it  was  solemnly  affirmed  became 
of  a  remarkably  black  color  after  having  been  some 
time  worn,  and  that  his  own  brother  had  been  sub 
jected  to  this  extraordinary  treatment;  but  I  must 
add  that  my  schoolmate  drew  a  bow  of  remarkable 
length,  strength,  and  toughness  for  his  tender  years. 


0  Severall  CTiirurgicatt  Treatises.     London.     1676.     p.  246. 


6  MEDICAL   ESSAYS. 

One  of  the  most  curious  examples  of  the  fallacy  of 
popular  belief  and  the  uncertainty  of  asserted  facts 
in  medical  experience  is  to  be  found  in  the  history  of 
the  UNGUENTUM  ARMARIUM,  or  WEAPON  OINTMENT. 

Fabricius  Hildanus,  whose  name  is  familiar  to  every 
surgical  scholar,  and  Lord  Bacon,  who  frequently 
dipped  a  little  into  medicine,  are  my  principal  au 
thorities  for  the  few  circumstances  I  shall  mention 
regarding  it.  The  Weapon  Ointment  was  a  prepara 
tion  used  for  the  healing  of  wounds,  but  instead  of 
its  being  applied  to  them,  the  injured  part  was  washed 
and  bandaged,  and  the  weapon  with  which  the  wound 
was  inflicted  was  carefully  anointed  with  the  un 
guent.  Empirics,  ignorant  barbers,  and  men  of  that 
sort,  are  said  to  have  especially  employed  it.  Still 
there  were  not  wanting  some  among  the  more  respect 
able  members  of  the  medical  profession  who  sup 
ported  its  claims.  The  composition  of  this  ointment 
was  complicated,  in  the  different  formula  given  by 
different  authorities ;  but  some  substances  addressed 
to  the  imagination,  rather  than  the  wound  or  weapon, 
entered  into  all.  Such  were  portions  of  mummy,  of 
human  blood,  and  of  moss  from  the  skull  of  a  thief 
hung  in  chains. 

Hildanus  was  a  wise  and  learned  man,  one  of  the 
best  surgeons  of  his  time.  He  was  fully  aware  that  a 
part  of  the  real  secret  of  the  Unguentum  Armarium 
consisted  in  the  washing  and  bandaging  the  wound 
and  then  letting  it  alone.  But  he  could  not  resist 
the  solemn  assertions  respecting  its  efficacy ;  he  gave 
way  before  the  outcry  of  facts,  and  therefore,  instead 
of  denying  all  their  pretensions,  he  admitted  and 
tried  to  account  for  them  upon  supernatural  grounds. 
As  the  virtue  of  those  applications,  he  says,  which 


HOMCEOPATHY   AND   ITS   KINDRED   DELUSIONS.      T 

are  made  to  the  weapon  cannot  reach  the  wound,  and 
as  they  can  produce  no  effect  without  contact,  it  fol 
lows,  of  necessity,  that  the  Devil  must  have  a  hand 
in  the  business ;  and  as  he  is  by  far  the  most  long 
headed  and  experienced  of  practitioners,  he  cannot 
find  this  a  matter  of  any  great  difficulty.  Hildanus 
himself  reports,  in  detail,  the  case  of  a  lady  who  had 
received  a  moderate  wound,  for  which  the  Unguen- 
tum  Armarium  was  employed  without  the  slightest 
use.  Yet  instead  of  receiving  this  flat  case  of  failure 
as  any  evidence  against  the  remedy,  he  accounts  for 
its  not  succeeding  by  the  devout  character  of  the 
lady,  and  her  freedom  from  that  superstitious  and 
over-imaginative  tendency  which  the  Devil  requires 
in  those  who  are  to  be  benefited  by  his  devices. 

Lord  Bacon  speaks  of  the  Weapon  Ointment,  in  his 
Natural  History,  as  having  in  its  favor  the  testimony 
of  men  of  credit,  though,  in  his  own  language,  he 
himself  "  as  yet  is  not  fully  inclined  to  believe  it.'* 
His  remarks  upon  the  asserted  facts  respecting  it 
show  a  mixture  of  wise  suspicion  and  partial  belief. 
He  does  not  like  the  precise  directions  given  as  to  the 
circumstances  under  which  the  animals  from  which 
some  of  the  materials  were  obtained  were  to  be 
killed  ;  for  he  thought  it  looked  like  a  provision  for 
an  excuse  in  case  of  failure,  by  laying  the  fault  to 
the  omission  of  some  of  these  circumstances.  But 
he  likes  well  that  "  they  do  not  observe  the  confect- 
ing  of  the  Ointment  under  any  certain  constellation  ; 
which  is  commonly  the  excuse  of  magical  medicines, 
when  they  fail,  that  they  were  not  made  under  a  fit 
figure  of  heaven."  °  It  was  pretended  that  if  the 

°  This  was  a  mistake,  however,  since  the  two  recipes  given  by 
Hildanus  are  both  very  explicit  as  to  the  aspect  of  the  heavens 
required  for  different  stages  of  the  process. 


8  MEDICAL  ESSAYS. 

offending  weapon  could  not  be  had,  it  would  serve 
the  purpose  to  anoint  a  wooden  one  made  like  it. 
"  This,"  says  Bacon,  "  I  should  doubt  to  be  a  device 
to  keep  this  strange  form  of  cure  in  request  and  use ; 
because  many  times  you  cannot  come  by  the  weapon 
itself."  And  in  closing  his  remarks  on  the  statements 
of  the  advocates  of  the  ointment,  he  says,  "  Lastly, 
it  will  cure  a  beast  as  well  as  a  man,  which  I  like 
best  of  all  the  rest,  because  it  subjecteth  the  matter 
to  an  easy  trial."  It  is  worth  remembering,  that 
more  than  two  hundred  years  ago,  when  an  absurd 
and  fantastic  remedy  was  asserted  to  possess  won 
derful  power,  and  when  sensible  persons  ascribed  its 
pretended  influence  to  imagination,  it  was  boldly 
answered  that  the  cure  took  place  when  the  wounded 
party  did  not  know  of  the  application  made  to  the 
weapon,  and  even  when  a  brute  animal  was  the  sub 
ject  of  the  experiment,  and  that  this  assertion,  lie  as 
we  all  know  it  was,  came  in  such  a  shape  as  to  shake 
the  incredulity  of  the  keenest  thinker  of  his  time. 
The  very  same  assertion  has  been  since  repeated  in 
favor  of  Perkinism,  and,  since  that,  of  Homo3opathy. 

The  same  essential  idea  as  that  of  the  Weapon 
Ointment  reproduced  itself  in  the  still  more  famous 
SYMPATHETIC  POWDER.  This  Powder  was  said  to 
have  the  faculty,  if  applied  to  the  blood-stained  gar 
ments  of  a  wounded  person,  to  cure  his  injuries, 
even  though  he  were  at  a  great  distance  at  the  time. 
A  friar,  returning  from  the  East,  brought  the  recipe 
to  Europe  somewhat  before  the  middle  of  the  seven 
teenth  century.  The  Grand  Duke  of  Florence,  in 
which  city  the  friar  was  residing,  heard  of  his  cures, 
and  tried,  but  without  success,  to  obtain  his  secret 
Sir  Kenelm  Digby,  an  Englishman  well  known  to 


HOMOEOPATHY  AND   ITS   KINDRED  DELUSIONS.      9 

fame,  was  fortunate  enough  to  do  him  a  favor,  which 
wrought  upon  his  feelings  and  induced  him  to  impart 
to  his  benefactor  the  composition  of  his  extraordinary 
Powder.  This  English  knight  was  at  different  pert 
ods  of  his  life  an  admiral,  a  theologian,  a  critic,  a  meta 
physician,  a  politician,  and  a  disciple  of  Alchemy. 
As  is  not  unfrequent  with  versatile  and  inflamma 
ble  people,  he  caught  fire  at  the  first  spark  of  a  new 
medical  discovery,  and  no  sooner  got  home  to  Eng 
land  than  he  began  to  spread  the  conflagration. 

"An  opportunity  soon  offerea  itself  to  try  the 
powers  of  the  famous  powder.  Mr.  J.  Howell,  having 
been  wounded  in  endeavoring  to  part  two  of  his 
friends  who  were  fighting  a  duel,  submitted  himself 
to  a  trial  of  the  Sympathetic  Powder.  Four  days 
after  he  received  his  wounds,  Sir  Kenelm  dipped  one 
of  Mr.  Howell's  garters  in  a  solution  of  the  Powder, 
and  immediately,  it  is  said,  the  wounds,  which  were 
very  painful,  grew  easy,  although  the  patient,  who 
was  conversing  in  a  corner  of  the  chamber,  had  not 
the  least  idea  of  what  was  doing  with  his  garter. 
He  then  returned  home,  leaving  his  garter  in  the 
hands  of  Sir  Kenelm,  who  had  hung  it  up  to  dry, 
when  Mr.  Howell  sent  his  servant  in  a  great  hurry 
to  tell  him  that  his  wounds  were  paining  him  horri 
bly  ;  the  garter  was  therefore  replaced  in  the  solution 
of  the  Powder,  and  the  patient  got  well  after  five  or 
six  days  of  its  continued  immersion." 

"  King  James  First,  his  son  Charles  the  First,  the 
Duke  of  Buckingham,  then  prime  minister,  and  all 
the  principal  personages  of  the  time,  were  cognizant 
of  this  fact ;  and  James  himself,  being  curious  to 
know  the  secret  of  this  remedy,  asked  it  of  Sir 
Kenelm,  who  revealed  it  to  him,  and  his  Majesty  had 


10  MEDICAL  ESSAYS. 

the  opportunity  of  making  several  trials  of  its  efficacy, 
which  all  succeeded  in  a  surprising  manner."  a 

The  king's  physician,  Dr.  Mayerne,  was  made  mas 
ter  of  the  secret,  which  he  carried  to  France  and  com 
municated  to  the  Duke  of  Mayenne,  who  performed 
many  cures  by  means  of  it,  and  taught  it  to  his  sur 
geon,  who,  after  the  Duke's  death,  sold  it  to  many 
distinguished  persons,  by  whose  agency  it  soon  ceased 
to  be  a  secret.  What  was  this  wonderful  substance 
which  so  astonished  kings,  princes,  dukes,  knights,  and 
doctors  ?  Nothing  but  powdered  blue  vitriol.  But  it 
was  made  to  undergo  several  processes  that  conferred 
on  it  extraordinary  virtues.  Twice  or  thrice  it  was  to 
be  dissolved,  filtered,  and  crystallized.  The  crystals 
were  to  be  laid  in  the  sun  during  the  months  of  June, 
July,  and  August,  taking  care  to  turn  them  carefully 
that  all  should  be  exposed.  Then  they  were  to  be 
powdered,  triturated,  and  again  exposed  to  the  sun, 
again  reduced  to  a  very  fine  powder,  and  secured  in  a 
vessel,  while  hot,  from  the  sunshine.  If  there  seem 
anything  remarkable  in  the  fact  of  such  astonishing 
properties  being  developed  by  this  process,  it  must  be 
from  our  short-sightedness,  for  common  salt  and  char 
coal  develop  powers  quite  as  marvellous  after  a  certain 
number  of  thumps,  stirs,  and  shakes,  from  the  hands 
of  modern  workers  of  miracles.  In  fact  the  Unguen- 
tum  Armarium  and  Sympathetic  Powder  resemble 
some  more  recent  prescriptions ;  the  latter  consisting 
in  an  infinite  dilution  of  the  common  dose  in  which 
remedies  are  given,  and  the  two  former  in  an  infinite 
dilution  of  the  common  distance  at  which  they  axe 
applied.  

•  Diet,  des  Sciences  Medicates. 


HOM<EOPATHY  AND   ITS   KINDRED   DELUSIONS.      11 

Whether  philosophers,  and  more  especially  meta 
physicians,  have  any  peculiar  tendency  to  dabble  in 
drugs  and  dose  themselves  with  physic,  is  a  question 
which  might  suggest  itself  to  the  reader  of  their  biog 
raphies. 

When  Bishop  Berkeley  visited  the  illustrious  Male- 
branche  at  Paris,  he  found  him  in  his  cell,  cooking  in 
a  small  pipkin  a  medicine  for  an  inflammation  of  the 
lungs,  from  which  he  was  suffering ;  and  the  disease, 
being  unfortunately  aggravated  by  the  vehemence  of 
their  discussion,  or  the  contents  of  the  pipkin,  carried 
him  off  in  the  course  of  a  few  days.  Berkeley  him 
self  afforded  a  remarkable  illustration  of  a  truth  which 
has  long  been  known  to  the  members  of  one  of  the 
learned  professions,  namely,  that  no  amount  of  talent, 
or  of  acquirements  in  other  departments,  can  rescue 
from  lamentable  folly  those  who,  without  something 
of  the  requisite  preparation,  undertake  to  experiment 
with  nostrums  upon  themselves  and  their  neighbors. 
The  exalted  character  of  Berkeley  is  thus  drawn  by 
Sir  James  Mackintosh  :  "  Ancient  learning,  exact  sci 
ence,  polished  society,  modern  literature,  and  the  fine 
arts,  contributed  to  adorn  and  enrich  the  mind  of  this 
accomplished  man.  All  his  contemporaries  agreed 
with  the  satirist  in  ascribing 

" '  To  Berkeley  every  virtue  under  heaven.' 

"  Even  the  discerning,  fastidious,  and  turbulent  At- 
terbury  said,  after  an  interview  with  him,  '  So  much 
understanding,  so  much  knowledge,  so  much  inno 
cence,  and  such  humility,  I  did  not  think  had  been  the 
portion  of  any  but  angels,  till  I  saw  this  gentleman.'  " 

But  among  the  writings  of  this  great  and  good  man 
is  an  Essay  of  the  most  curious  character,  illustrat- 


12  MEDICAL  ESSAYS. 

ing  his  weakness  upon  the  point  in  question,  and  enti 
tled,  "  Siris,  a  Chain  of  Philosophical  Keflections  and 
Inquiries  concerning  the  Virtues  of  TAB  WATER,  and 
divers  other  Subjects,"  —  an  essay  which  begins  with 
a  recipe  for  his  favorite  fluid,  and  slides  by  gentle 
gradations  into  an  examination  of  the  sublimest  doc 
trines  of  Plato.  To  show  how  far  a  man  of  honesty 
and  benevolence,  and  with  a  mind  of  singular  acute- 
ness  and  depth,  may  be  run  away  with  by  a  favorite 
notion  on  a  subject  which  his  habits  and  education  do 
not  fit  him  to  investigate,  I  shall  give  a  short  account 
of  this  Essay,  merely  stating  that  as  all  the  supposed 
virtues  of  Tar  Water,  made  public  in  successive  edi 
tions  of  his  treatise  by  so  illustrious  an  author,  have 
not  saved  it  from  neglect  and  disgrace,  it  may  be  fairly 
assumed  that  they  were  mainly  imaginary. 

The  bishop,  as  is  usual  in  such  cases,  speaks  of  him 
self  as  indispensably  obliged,  by  the  duty  he  owes  to 
mankind,  to  make  his  experience  public.  Now  this 
was  by  no  means  evident,  nor  does  it  follow  in  general, 
that  because  a  man  has  formed  a  favorable  opinion  of 
a  person  or  a  thing  he  has  not  the  proper  means  of 
thoroughly  understanding,  he  shall  be  bound  to  print 
it,  and  thus  give  currency  to  his  impressions,  which 
may  be  erroneous,  and  therefore  injurious.  He  would 
have  done  much  better  to  have  laid  his  impressions 
before  some  experienced  physicians  and  surgeons,  such 
as  Dr.  Mead  and  Mr.  Cheselden,  to  have  asked  them 
to  try  his  experiment  over  again,  and  have  been  guided 
by  their  answers.  But  the  good  bishop  got  excited ;  he 
pleased  himself  with  the  thought  that  he  had  discov 
ered  a  great  panacea ;  and  having  once  tasted  the  be 
witching  cup  of  self-quackery,  like  many  before  and 
since  his  time,  he  was  so  infatuated  with  the  draught 


HOMOEOPATHY  AND   ITS   KINDRED   DELUSIONS.      18 

that  he  would  insist  on  pouring  it  down  the  throats  of 
his  neighbors  and  all  mankind. 

The  precious  fluid  was  made  by  stirring  a  gallon  of 
water  with  a  quart  of  tar,  leaving  it  forty-eight  hours, 
and  pouring  off  the  clear  water.  Such  was  the  spe 
cific  which  the  great  metaphysician  recommended  for 
averting  and  curing  all  manner  of  diseases.  It  was, 
if  he  might  be  believed,  a  preventive  of  the  small-pox, 
and  of  great  use  in  the  course  of  the  disease.  It 
was  a  cure  for  impurities  of  the  blood,  coughs,  pleu 
risy,  peripneumony,  erysipelas,  asthma,  indigestion,  ca- 
chexia,  hysterics,  dropsy,  mortification,  scurvy,  and 
hypochondria.  It  was  of  great  use  in  gout  and  fevers, 
and  was  an  excellent  preservative  of  the  teeth  and 
gums ;  answered  all  the  purpose  of  Elixir  Proprietatis, 
Stoughton's  drops,  diet  drinks,  and  mineral  waters ; 
was  particularly  to  be  recommended  to  sea-faring  per- 
Bons,  ladies,  and  men  of  studious  and  sedentary  lives ; 
could  never  be  taken  too  long,  but,  on  the  contrary, 
produced  advantages  which  sometimes  did  not  begin 
to  show  themselves  for  two  or  three  months. 

"  From  my  representing  Tar  Water  as  good  for  so 
many  things,"  says  Berkeley,  "  some  perhaps  may  con 
clude  it  is  good  for  nothing.  But  charity  obligeth  me 
to  say  what  I  know,  and  what  I  think,  however  it  may 
be  taken.  Men  may  censure  and  object  as  they  please, 
but  I  appeal  to  time  and  experiment.  Effects  mis- 
imputed,  cases  wrong  told,  circumstances  overlooked, 
perhaps,  too,  prejudices  and  partialities  against  truth, 
may  for  a  time  prevail  and  keep  her  at  the  bottom  of 
her  well,  from  whence  nevertheless  she  emergeth  sooner 
or  later,  and  strikes  the  eyes  of  all  who  do  not  keep 
them  shut."  I  cannot  resist  the  temptation  of  illus 
trating  the  bishop's  belief  in  the  wonderful  powers 


14  MEDICAL  ESSAYS. 

of  his  remedy,  by  a  few  sentences  from  different  parts 
of  his  essay.  "  The  hardness  of  stubbed  vulgar  consti 
tutions  renders  them  insensible  of  a  thousand  things 
that  fret  and  gall  those  delicate  people,  who,  as  if  their 
skin  was  peeled  off,  feel  to  the  quick  everything  that 
touches  them.  The  tender  nerves  and  low  spirits  of 
such  poor  creatures  would  be  much  relieved  by  the 
use  of  Tar  Water,  which  might  prolong  and  cheer  their 
lives."  "  It  [the  Tar  Water]  may  be  made  stronger 
for  brute  beasts,  as  horses,  in  whose  disorders  I  have 
found  it  very  useful."  "  This  same  water  will  also 
give  charitable  relief  to  the  ladies,  who  often  want  it 
more  than  the  parish  poor  ;  being  many  of  them  never 
able  to  make  a  good  meal,  and  sitting  pale,  puny,  and 
forbidden,  like  ghosts,  at  their  own  table,  victims  of 
vapors  and  indigestion."  It  does  not  appear  among 
the  virtues  of  Tar  Water  that  "  children  cried  for  it," 
as  for  some  of  our  modern  remedies,  but  the  bishop 
says,  "  I  have  known  children  take  it  for  above  six 
months  together  with  great  benefit,  and  without  any 
inconvenience ;  and  after  long  and  repeated  experience 
I  do  esteem  it  a  most  excellent  diet  drink,  fitted  to  all 
seasons  and  ages."  After  mentioning  its  usefulness 
in  febrile  complaints,  he  says :  "I  have  had  all  this 
confirmed  by  my  own  experience  in  the  late  sickly 
season  of  the  year  one  thousand  seven  hundred  and 
forty-one,  having  had  twenty-five  fevers  in  my  own 
family  cured  by  this  medicinal  water,  drunk  copi 
ously."  And  to  finish  these  extracts  with  a  most  im 
portant  suggestion  for  the  improvement  of  the  British 
nation  :  "  It  is  much  to  be  lamented  that  our  Insulars, 
who  act  and  think  so  much  for  themselves,  should  yet, 
from  grossness  of  air  and  diet,  grow  stupid  or  doat 
sooner  than  other  people,  who,  by  virtue  of  elastic  aiifc 


HOMOEOPATHY   AND   ITS   KINDRED   DELUSIONS.     15 

water-drinking,  and  light  food,  preserve  their  faculties 
to  extreme  old  age ;  an  advantage  which  may  perhaps 
be  approached,  if  not  equaled,  even  in  these  regions, 
by  Tar  Water,  temperance,  and  early  hours." 

Berkeley  died  at  the  age  of  about  seventy ;  he  might 
have  lived  longer,  but  his  fatal  illness  was  so  sudden 
that  there  was  not  time  enough  to  stir  up  a  quart  of 
the  panacea.  He  was  an  illustrious  man,  but  he  held 
two  very  odd  opinions  ;  that  tar  water  was  everything, 
and  that  the  whole  material  universe  was  nothing. 


Most  of  those  present  have  at  some  time  in  their 
lives  heard  mention  made  of  the  METALLIC  TRAC 
TORS,  invented  by  one  Dr.  Perkins,  an  American,  and 
formerly  enjoying  great  repute  for  the  cure  of  vari 
ous  diseases.  Many  have  seen  or  heard  of  a  satirical 
poem,  written  by  one  of  our  own  countrymen  also, 
about  forty  years  since,  and  called  "  Terrible  Tractora- 
tion."  The  Metallic  Tractors  are  now  so  utterly  aban 
doned  that  I  have  only  by  good  fortune  fallen  upon  a 
single  one  of  a  pair,  to  show  for  the  sake  of  illustra 
tion.  For  more  than  thirty  years  this  great  discovery, 
which  was  to  banish  at  least  half  the  evils  which  afflict 
humanity,  has  been  sleeping  undisturbed  in  the  grave 
of  oblivion.  Not  a  voice  has,  for  this  long  period, 
been  raised  in  its  favor ;  its  noble  and  learned  patrons, 
its  public  institutions,  its  eloquent  advocates,  its  bril 
liant  promises  are  all  covered  with  the  dust  of  silent 
neglect ;  and  of  the  generation  which  has  sprung  up 
since  the  period  when  it  flourished,  very  few  know 
anything  of  its  history,  and  hardly  even  the  title  which 
in  its  palmy  days  it  bore  of  PERKINISM.  Taking  it  as 
settled,  then,  as  no  one  appears  to  answer  for  it,  that 


16  MEDICAL  ESSAYS. 

Perkinism  is  entirely  dead  and  gone,  that  both  in  pub 
lic  and  private,  officially  and  individually,  its  forme* 
adherents  even  allow  it  to  be  absolutely  defunct,  I  se 
lect  it  for  anatomical  examination.  If  this  pretended 
discovery  was  made  public ;  if  it  was  long  kept  before 
the  public ;  if  it  was  addressed  to  the  people  of  dif 
ferent  countries ;  if  it  was  formally  investigated  by 
scientific  men,  and  systematically  adopted  by  benev 
olent  persons,  who  did  everything  in  their  power  to 
diffuse  the  knowledge  and  practice  of  it;  if  various 
collateral  motives,  such  as  interest  and  vanity,  were 
embarked  in  its  cause;  if,  notwithstanding  all  these 
things,  it  gradually  sickened  and  died,  then  the  con 
clusion  seems  a  fair  one,  that  it  did  not  deserve  to  live. 
Contrasting  its  failure  with  its  high  pretensions,  it  is 
fair  to  call  it  an  imposition ;  whether  an  expressly  fraud 
ulent  contrivance  or  not,  some  might  be  ready  to  ques 
tion.  Everything  historically  shown  to  have  happened 
concerning  the  mode  of  promulgation,  the  wide  diffu 
sion,  the  apparent  success  of  this  delusion,  the  respect 
ability  and  enthusiasm  of  its  advocates,  is  of  great  in 
terest  in  showing  to  what  extent  and  by  what  means  a 
considerable  part  of  the  community  may  be  led  into 
the  belief  of  that  which  is  to  be  eventually  considered 
as  an  idle  folly.  If  there  is  any  existing  folly,  fraud 
ulent  or  innocent  in  its  origin,  which  appeals  to  cer 
tain  arguments  for  its  support ;  provided  that  the  very 
same  arguments  can  be  shown  to  have  been  used  for 
Perkinism  with  as  good  reason,  they  will  at  once  fall 
to  the  ground.  Still  more,  if  it  shall  appear  that  the 
general  course  of  any  existing  delusion  bears  a  strong 
resemblance  to  that  of  Perkinism,  that  the  former  is 
most  frequently  advocated  by  the  same  class  of  per 
rons  who  were  conspicuous  in  behalf  of  the  latter,  and 


HOMCEOPATHY  AND  ITS  KINDKED  DELUSIONS.      17 

treated  with  contempt  or  opposed  by  the  same  kind  of 
persons  who  thus  treated  Perkinism;  if  the  facts  in 
favor  of  both  have  a  similar  aspect ;  if  the  motives  of 
their  originators  and  propagators  may  be  presumed  to 
have  been  similar ;  then  there  is  every  reason  to  sup- 
pose  that  the  existing  folly  will  follow  in  the  footsteps 
of  the  past,  and  after  displaying  a  given  amount  of 
cunning  and  credulity  in  those  deceiving  and  deceived, 
will  drop  from  the  public  view  like  a  fruit  which  has 
ripened  into  spontaneous  rottenness,  and  be  succeeded 
by  the  fresh  bloom  of  some  other  delusion  required  by 
the  same  excitable  portion  of  the  community. 

Dr.  Elisha  Perkins  was  born  at  Norwich,  Connect 
icut,  in  the  year  1740.  He  had  practised  his  profes 
sion  with  a  good  local  reputation  for  many  years,  when 
he  fell  upon  a  course  of  experiments,  as  it  is  related, 
which  led  to  his  great  discovery.  He  conceived  the 
idea  that  metallic  substances  might  have  the  effect  of 
removing  diseases,  if  applied  in  a  certain  manner ;  a 
notion  probably  suggested  by  the  then  recent  experi 
ments  of  Galvani,  in  which  muscular  contractions  were 
found  to  be  produced  by  the  contact  of  two  metals 
with  the  living  fibre.  It  was  in  1796  that  his  dis 
covery  was  promulgated  in  the  shape  of  the  Metallic 
Tractors,  two  pieces  of  metal,  one  apparently  iron 
and  the  other  brass,  about  three  inches  long,  blunt  at 
one  end  and  pointed  at  the  other.  These  instruments 
were  applied  for  the  cure  of  different  complaints,  such 
as  rheumatism,  local  pains,  inflammations,  and  even 
tumors,  by  drawing  them  over  the  affected  part  very 
lightly  for  about  twenty  minutes.  Dr.  Perkins  took 
out  a  patent  for  his  discovery,  and  travelled  about  the 
country  to  diffuse  the  new  practice.  He  soon  found 
numerous  advocates  of  his  discovery,  many  of  them  of 


18  MEDICAL  ESSAYS. 

high  standing  and  influence.  In  the  year  1798  the 
tractors  had  crossed  the  Atlantic,  and  were  publicly  em 
ployed  in  the  Royal  Hospital  at  Copenhagen.  About 
the  same  time  the  son  of  the  inventor,  Mr.  Benjamin 
Douglass  Perkins,  carried  them  to  London,  where  they 
soon  attracted  attention.  The  Danish  physicians  pub 
lished  an  account  of  their  cases,  containing  numerous 
instances  of  alleged  success,  in  a  respectable  octavo 
volume.  In  the  year  1804  an  establishment,  honored 
with  the  name  of  the  Perkinean  Institution,  was 
founded  in  London.  The  transactions  of  this  institu 
tion  were  published  in  pamphlets,  the  Perkinean  So 
ciety  had  public  dinners  at  the  Crown  and  Anchor, 
and  a  poet  celebrated  their  medical  triumph  in  strains 
like  these :  — 

"  See,  pointed  metals,  blest  with  power  t'  appease 
The  ruthless  rage  of  merciless  disease, 
O'er  the  frail  part  a  subtle  fluid  pour, 
Drenched  with  invisible  Galvanic  shower, 
Till  the  arthritic  staff  and  crutch  forego, 
And  leap  exulting  like  the  bounding  roe  !  '* 

While  all  these  things  were  going  on,  Mr.  Benja 
min  Douglass  Perkins  was  calmly  pocketing  money, 
so  that  after  some  half  a  dozen  years  he  left  the  coun 
try  with  more  than  ten  thousand  pounds,  which  had 
been  paid  him  by  the  believers  in  Great  Britain.  But 
in  spite  of  all  this  success,  and  the  number  of  those  in 
terested  and  committed  in  its  behalf,  Perkinism  soon 
began  to  decline,  and  in  1811  the  Tractors  are  spoken 
of  by  an  intelligent  writer  as  being  almost  forgotten. 
Such  was  the  origin  and  duration  of  this  doctrine  and 
practice,  into  the  history  of  which  we  will  now  look  a 
little  more  narrowly. 

Let  us  see,  then,  by  whose  agency  this  delusion 


HOMCEOPATHX  AND   ITS   KINDRED   DELUSIONS.      19 

was  established  and  kept  up ;  whether  it  was  princi 
pally  by  those  who  were  accustomed  to  medical  pur 
suits,  or  those  whose  habits  and  modes  of  reasoning 
were  different ;  whether  it  was  with  the  approbation 
of  those  learned  bodies  usually  supposed  to  take  an 
interest  in  scientific  discoveries,  or  only  of  individuals 
whose  claims  to  distinction  were  founded  upon  their 
position  in  society,  or  political  station,  or  literary  em 
inence  ;  whether  the  judicious  or  excitable  classes  en 
tered  most  deeply  into  it;  whether,  in  short,  the  scien 
tific  men  of  that  time  were  deceived,  or  only  intruded 
upon,  and  shouted  down  for  the  moment  by  persons 
who  had  no  particular  call  to  invade  their  precincts. 

Not  much,  perhaps,  was  to  be  expected  of  the 
Medical  Profession  in  the  way  of  encouragement. 
One  Dr.  Fuller,  who  wrote  in  England,  himself  a 
Perkinist,  thus  expressed  his  opinion :  "  It  must  be 
an  extraordinary  exertion  of  virtue  and  humanity  for 
a  medical  man,  whose  livelihood  depends  either  on 
the  sale  of  drugs,  or  on  receiving  a  guinea  for  writing 
a  prescription,  which  must  relate  to  those  drugs,  to 
say  to  his  patient,  '  You  had  better  purchase  a  set  of 
Tractors  to  keep  in  your  family ;  they  will  cure  you 
without  the  expense  of  my  attendance,  or  the  danger 
of  the  common  medical  practice.'  For  very  obvious 
reasons  medical  men  must  never  be  expected  to  rec 
ommend  the  use  of  Perkinism.  The  Tractors  must 
trust  for  their  patronage  to  the  enlightened  and  phil 
anthropic  out  of  the  profession,  or  to  medical  men 
retired  from  practice,  and  who  know  of  no  other 
interest  than  the  luxury  of  relieving  the  distressed. 
And  I  do  not  despair  of  seeing  the  day  when  but 
very  few  of  this  description  as  well  as  private  families 
be  without  them." 


20  MEDICAL  ESSAYS. 

Whether  the  motives  assigned  by  this  medical  man 
to  his  professional  brethren  existed  or  not,  it  is  true 
that  Dr.  Perkins  did  not  gain  a  great  deal  at  their 
hands.  The  Connecticut  Medical  Society  expelled 
him  in  1797  for  violating  their  law  against  the  use  of 
nostrums,  or  secret  remedies.  The  leading  English 
physicians  appear  to  have  looked  on  with  singular 
apathy  or  contempt  at  the  miracles  which  it  was  pre 
tended  were  enacting  in  the  hands  of  the  apostles  of 
the  new  practice.  In  looking  over  the  reviews  of  the 
time,  I  have  found  little  beyond  brief  occasional 
notices  of  their  pretensions ;  the  columns  of  these 
journals  being  occupied  with  subjects  of  more  per 
manent  interest.  The  state  of  things  in  London  is 
best  learned,  however,  from  the  satirical  poem  to 
which  I  have  already  alluded  as  having  been  written 
at  the  period  referred  to.  This  was  entitled,  "  Terri 
ble  Tractoration !  !  A  Poetical  Petition  against  Gal 
vanizing  Trumpery  and  the  Perkinistic  Institution. 
Most  respectfully  addressed  to  the  Royal  College  of 
Physicians,  by  Christopher  Caustic,  M.  D.,  LL.  D., 
A.  S.  S.,  Fellow  of  the  Royal  College  of  Physicians, 
Aberdeen,  and  Honorary  Member  of  no  less  than 
nineteen  very  learned  Societies."  Two  editions  of 
this  work  were  published  in  London  in  the  years 
1803  and  1804,  and  one  or  two  have  been  published 
in  this  country. 

"  Terrible  Tractoration  "  is  supposed,  by  those  who 
never  read  it,  to  be  a  satire  upon  the  follies  of  Per 
kins  and  his  followers.  It  is,  on  the  contrary,  a  most 
zealous  defence  of  Perkinism,  and  a  fierce  attack 
upon  its  opponents,  most  especially  upon  such  of  the 
medical  profession  as  treated  the  subject  with  neglect 
or  ridicule.  The  Royal  College  of  Physicians  was  the 


HOMCEOPATHY  AND   ITS   KINDRED   DELUSIONS.      21 

more  peculiar  object  of  the  attack,  but  with  this  body, 
the  editors  of  some  of  the  leading  periodicals,  and  sev 
eral  physicians  distinguished  at  that  time,  and  even 
now  remembered  for  their  services  to  science  and  hu 
manity,  were  involved  in  unsparing  denunciations. 
The  work  is  by  no  means  of  the  simply  humorous 
character  it  might  be  supposed,  but  is  overloaded  with 
notes  of  the  most  seriously  polemical  nature.  Much 
of  the  history  of  the  subject,  indeed,  is  to  be  looked 
for  in  this  volume. 

It  appears  from  this  work  that  the  principal  mem 
bers  of  the  medical  profession,  so  far  from  hailing  Mr. 
Benjamin  Douglass  Perkins  as  another  Harvey  or 
Jenner,  looked  very  coldly  upon  him  and  his  Trac 
tors  ;  and  it  is  now  evident  that,  though  they  were 
much  abused  for  so  doing,  they  knew  very  well  what 
they  had  to  deal  with,  and  were  altogether  in  the 
right.  The  delusion  at  last  attracted  such  an  amount 
of  attention  as  to  induce  Dr.  Haygarth  and  some 
others  of  respectable  standing  to  institute  some  exper 
iments  which  I  shall  mention  in  their  proper  place, 
the  result  of  which  might  have  seemed  sufficient  to 
show  the  emptiness  of  the  whole  contrivance. 

The  Royal  Society,  that  learned  body  which  for 
ages  has  constituted  the  best  tribunal  to  which  Britain 
can  appeal  in  questions  of  science,  accepted  Mr. 
Perkins's  Tractors  and  the  book  written  about  them, 
passed  the  customary  vote  of  thanks,  and  never 
thought  of  troubling  itself  further  in  the  investiga 
tion  of  pretensions  of  such  an  aspect.  It  is  not  to 
be  denied  that  a  considerable  number  of  physicians 
did  avow  themselves  advocates  of  the  new  practice ; 
but  out  of  the  whole  catalogue  of  those  who  were 
gublicly  proclaimed  as  such,  no  one  has  ever  been 


22  MEDICAL  ESSAYS. 

known,  t*o  far  as  I  am  aware,  to  the  scientific 
except  in  connection  with  the  short-lived  notoriety 
of  Perkinism.  Who  were  the  people,  then,  to  whose 
activity,  influence,  or  standing  with  the  community 
was  owing  all  the  temporary  excitement  produced  by 
the  Metallic  Tractors  ? 

First,  those  persons  who  had  been  induced  to  pur 
chase  a  pair  of  Tractors.  These  little  bits  of  brass 
and  iron,  the  intrinsic  value  of  which  might,  perhaps, 
amount  to  ninepence,  were  sold  at  five  guineas  a 
pair !  A  man  who  has  paid  twenty-five  dollars  for 
his  whistle  is  apt  to  blow  it  louder  and  longer  than 
other  people.  So  it  appeared  that  when  the  "  Per- 
kinean  Society  "  applied  to  the  possessors  of  Tractors 
in  the  metropolis  to  concur  in  the  establishment  of  a 
public  institution  for  the  use  of  these  instruments 
upon  the  poor,  "  it  was  found  that  only  five  out  of 
above  a  hundred  objected  to  subscribe,  on  account  of 
their  want  of  confidence  in  the  efficacy  of  the  prac 
tice  ;  and  these,"  the  committee  observes,  "  there  is 
reason  to  believe,  never  gave  them  a  fair  trial,  proba 
bly  never  used  them  in  more  than  one  case,  and  that 
perhaps  a  case  in  which  the  Tractors  had  never  been 
recommended  as  serviceable."  "  Purchasers  of  the 
Tractors,"  said  one  of  their  ardent  advocates,  "  would 
be  among  the  last  to  approve  of  them  if  they  had  rea 
son  to  suppose  themselves  defrauded  of  five  guineas." 
He  forgot  poor  Moses,  with  his  "  gross  of  green  spec 
tacles,  with  silver  rims  and  shagreen  cases."  "  Dear 
mother,"  cried  the  boy,  "  why  won't  you  listen  to 
reason  ?  I  had  them  a  dead  bargain,  or  I  should  not 
have  bought  them.  The  silver  rims  alone  will  sell 
for  double  the  money." 

But  it  is  an  undeniable  fact,  that  many  persons  of 


HOMCEOPATHY   AND   ITS   KINDRED   DELUSIONS.      23 

considerable  standing,  and  in  some  instances  holding 
the  most  elevated  positions  in  society,  openly  patron 
ized  the  new  practice.  In  a  translation  of  a  work 
entitled  "Experiments  with  the  Metallic  Tractors," 
originally  published  in  Danish,  thence  rendered  suc 
cessively  into  German  and  English,  Mr.  Benjamin 
Perkins,  who  edited  the  English  edition,  has  given  a 
copious  enumeration  of  the  distinguished  individuals, 
both  in  America  and  Europe,  whose  patronage  he 
enjoyed.  He  goes  so  far  as  to  signify  that  ROYALTY 
itself  was  to  be  included  among  the  number.  When 
the  Perkinean  Institution  was  founded,  no  less  a 
person  than  Lord  Rivers  was  elected  President,  and 
eleven  other  individuals  of  distinction,  among  them 
Governor  Franklin,  son  of  Dr.  Franklin,  figured  as 
Vice-Presidents.  Lord  Henniker,  a  member  of  the 
Royal  Society,  who  is  spoken  of  as  a  man  of  judgment 
and  talents,  condescended  to  patronize  the  astonish 
ing  discovery,  and  at  different  times  bought  three 
pairs  of  Tractors.  When  the  Tractors  were  intro 
duced  into  Europe,  a  large  number  of  testimonials 
accompanied  them  from  various  distinguished  char 
acters  in  America,  the  list  of  whom  is  given  in  the 
translation  of  the  Danish  work  referred  to  as  follows : 
"Those  who  have  individually  stated  cases,  or  who 
have  presented  their  names  to  the  public  as  men  who 
approved  of  this  remedy,  and  acknowledged  them 
selves  instrumental  in  circulating  the  Tractors,  are 
fifty-six  in  number;  thirty-four  of  whom  are  phy 
sicians  and  surgeons,  and  many  of  them  of  the  first 
eminence,  thirteen  clergymen,  most  of  whom  are 
doctors  of  divinity,  and  connected  with  the  literary 
institutions  of  America;  among  the  remainder  are 
two  members  of  Congress,  one  professor  of  natural 


24  MEDICAL  ESSAYS. 

philosophy  in  a  college,  etc.,  etc."  It  seemed  to  be 
taken  rather  hardly  by  Mr.  Perkins  that  the  transla 
tors  of  the  work  which  he  edited,  in  citing  the  name? 
of  the  advocates  of  the  Metallic  Practice,  frequently 
omitted  the  honorary  titles  which  should  have  been 
annexed.  The  testimonials  were  obtained  by  the 
Danish  writer,  from  a  pamphlet  published  in  Amer 
ica,  in  which  these  titles  were  given  in  full.  Thus 
one  of  these  testimonials  is  from  "  John  Tyler,  Esq., 
a  magistrate  in  the  county  of  New  London,  and  late 
Brigadier-General  of  the  militia  in  that  State."  The 
*'  omission  of  the  General's  title "  is  the  subject  of 
complaint,  as  if  this  title  were  sufficient  evidence 
of  the  commanding  powers  of  one  of  the  patrons 
of  tractoration.  A  similar  complaint  is  made  when 
"  Calvin  Goddard,  Esq.,  of  Plainfield,  Attorney  at 
Law,  and  a  member  of  the  Legislature  of  the  State 
of  Connecticut,"  is  mentioned  without  his  titular 
honors,  and  even  on  account  of  the  omission  of  the 
proper  official  titles  belonging  to  "Nathan  Pierce, 
Esq.,  Governor  and  Manager  of  the  Almshouse  of 
Newburyport."  These  instances  show  the  great  im 
portance  to  be  attached  to  civil  and  military  dignities, 
in  qualifying  their  holders  to  judge  of  scientific  sub 
jects,  a  truth  which  has  not  been  overlooked  by  the 
legitimate  successors  of  the  Perkinists.  In  Great 
Britain,  the  Tractors  were  not  less  honored  than  in 
America,  by  the  learned  and  the  illustrious.  The 
"Perkinistic  Committee"  made  this  statement  in 
their  report :  "  Mr.  Perkins  has  annually  laid  before 
the  public  a  large  collection  of  new  cases  communi 
cated  to  him  for  that  purpose  by  disinterested  and 
intelligent  characters,  from  almost  every  quarter  of 
Great  Britain.  In  regard  to  the  competency  of  these 


HOM(EOPATHY   AND   ITS   KINDRED   DELUSIONS.      25 

vouchers,  it  will  be  sufficient  simply  to  state  that, 
amongst  others  whose  names  have  been  attached  to 
their  communications,  are  eight  professors,  in  four 
different  universities,  twenty-one  regular  Physicians, 
nineteen  Surgeons,  thirty  Clergymen,  twelve  of  whom 
are  Doctors  of  Divinity,  and  numerous  other  charac 
ters  of  equal  respectability." 

It  cannot  but  excite  our  notice  and  surprise  that 
the  number  of  clergymen  both  in  America  and  Great 
Britain  who  thrust  forward  their  evidence  on  this 
medical  topic  was  singularly  large  in  proportion  to 
that  of  the  members  of  the  medical  profession. 
Whole  pages  are  contributed  by  such  worthies  as 
the  Rev.  Dr.  Trotter  of  Hans  Place,  the  Rev.  War 
ing  Willett,  Chaplain  to  the  Earl  of  Dunmore,  the 
Rev.  Dr.  Clarke,  Chaplain  to  the  Prince  of  Wales. 
The  style  of  these  theologico- medical  communica 
tions  may  be  seen  in  the  following  from  a  divine 
who  was  also  professor  in  one  of  the  colleges  of  New 
England.  "  I  have  used  the  Tractors  with  success 
in  several  other  cases  in  my  own  family,  and  al 
though,  like  Naaman  the  Syrian,  I  cannot  tell  why 
the  waters  of  Jordan  should  be  better  than  Abana 
and  Pharpar,  rivers  of  Damascus ;  yet  since  expe 
rience  has  proved  them  so,  no  reasoning  can  change 
the  opinion.  Indeed,  the  causes  of  all  common  facts 
are,  we  think,  perfectly  well  known  to  us ;  and  it  is 
very  probable,  fifty  or  a  hundred  years  hence,  we 
shall  as  well  know  why  the  Metallic  Tractors  should 
in  a  few  minutes  remove  violent  pains,  as  we  now 
know  why  cantharides  and  opium  will  produce  oppo 
site  effects,  namely,  we  shall  know  very  little  about 
either  excepting  facts."  Fifty  or  a  hundred  years 
hence !  if  he  could  have  looked  forward  forty  years, 


26  MEDICAL  ESSAYS. 

he  would  have  seen  the  descendants  of  the  "  Perkin- 
istic"  philosophers  swallowing  infinitesimal  globules, 
and  knowing  and  caring  as  much  about  the  Tractors 
as  the  people  at  Saratoga  Springs  do  about  the  waters 
of  Abana  and  Pharpar. 

I  trust  it  will  not  be  thought  in  any  degree  disre 
spectful  to  a  profession  which  we  all  honor,  that  I 
have  mentioned  the  great  zeal  of  many  clergymen  in 
the  cause  of  Perkinism.  I  hope,  too,  that  I  may 
without  offence  suggest  the  causes  which  have  often 
led  them  out  of  their  own  province  into  one  to  which 
their  education  has  no  special  reference.  The  mem 
bers  of  that  profession  ought  to  be,  and  commonly 
are,  persons  of  benevolent  character.  Their  duties 
carry  them  into  the  midst  of  families,  and  particu 
larly  at  times  when  the  members  of  them  are  suffer 
ing  from  bodily  illness.  It  is  natural  enough  that  a 
strong  desire  should  be  excited  to  alleviate  sufferings 
which  may  have  defied  the  efforts  of  professional 
skill ;  as  natural  that  any  remedy  which  recommends 
itself  to  the  belief  or  the  fancy  of  the  spiritual  phy 
sician  should  be  applied  with  the  hope  of  benefit ; 
and  perfectly  certain  that  the  weakness  of  human 
nature,  from  which  no  profession  is  exempt,  will  lead 
him  to  take  the  most  nattering  view  of  its  effects 
upon  the  patient ;  his  own  sagacity  and  judgment 
being  staked  upon  the  success  of  the  trial.  The  in 
ventor  of  the  Tractors  was  aware  of  these  truths.  He 
therefore  sent  the  Tractors  gratuitously  to  many  cler 
gymen,  accompanied  with  a  formal  certificate  that 
the  holder  had  become  entitled  to  their  possession 
by  the  payment  of  five  guineas.  This  was  practised 
in  our  own  neighborhood,  and  I  remember  finding 
one  of  these  certificates,  so  presented,  which  proved 


HOMCEOPATHY   AND   ITS   KINDRED   DELUSIONS.      27 

that  amongst  the  risks  of  infancy  I  had  to  encounter 
Perkins's  Tractors.  Two  clergymen  of  Boston  and 
the  vicinity,  both  well  known  to  local  fame,  gave  in 
their  testimony  to  the  value  of  the  instruments  thus 
presented  to  them  ;  an  unusually  moderate  proportion, 
when  it  is  remembered  that  to  the  common  motives 
of  which  I  have  spoken  was  added  the  seduction  of  a 
gift  for  which  the  profane  public  was  expected  to  pay 
so  largely. 

It  was  remarkable,  also,  that  Perkinism,  which  had 
so  little  success  with  the  medical  and  scientific  part 
of  the  community,  found  great  favor  in  the  eyes  of  its 
more  lovely  and  less  obstinate  portion.  "  The  lady 
of  Major  Oxholm,"  —  I  quote  from  Mr.  Perkins's 
volume,  —  "  having  been  lately  in  America,  had  seen 
and  heard  much  of  the  great  effects  of  Perkinism. 
Influenced  by  a  most  benevolent  disposition,  she 
brought  these  Tractors  and  the  pamphlet  with  her 
to  Europe,  with  a  laudable  desire  of  extending  their 
utility  to  her  suffering  countrymen."  Such  was  the 
channel  by  which  the  Tractors  were  conveyed  to  Den 
mark,  where  they  soon  became  the  ruling  passion. 
The  workmen,  says  a  French  writer,  could  not  man- 

'  V 

ufacture  them  fast  enough.  Women  carried  them 
about  their  persons,  and  delighted  in  bringing  them 
into  general  use.  To  what  extent  the  Tractors  were 
favored  with  the  patronage  of  English  and  American 
ladies,  it  is  of  course  not  easy  to  say,  except  on  gen 
eral  principles,  as  their  names  were  not  brought  be- 
fore  the  public.  But  one  of  Dr.  Haygarth's  stories 
may  lead  us  to  conjecture  that  there  was  a  class  of 
female  practitioners  who  went  about  doing  good  with 
the  Tractors  in  England  as  well  as  in  Denmark.  A 
certain  lady  had  the  misfortune  to  have  a  spot  as  big 


28  MEDICAL  ESSAYS. 

as  a  silver  penny  at  the  corner  of  her  eye,  caused  by 
a  bruise,  or  some  such  injury.  Another  lady,  who 
was  a  friend  of  hers,  and  a  strong  believer  in  Per- 
kinism,  was  very  anxious  to  try  the  effects  of  trac- 
toration  upon  this  unfortunate  blemish.  The  patient 
consented ;  the  lady  "  produced  the  instruments,  and, 
after  drawing  them  four  or  five  times  over  the  spot, 
declared  that  it  changed  to  a  paler  color,  and  on  re 
peating  the  use  of  them  a  few  minutes  longer,  that 
it  had  almost  vanished,  and  was  scarcely  visible,  and 
departed  in  high  triumph  at  her  success."  The  lady 
who  underwent  the  operation  assured  the  narrator 
"  that  she  looked  in  the  glass  immediately  after,  and 
that  not  the  least  visible  alteration  had  taken  place." 

It  would  be  a  very  interesting  question,  what  was 
the  intellectual  character  of  those  persons  most  con 
spicuous  in  behalf  of  the  Perkinistic  delusion  ?  Such 
an  inquiry  might  bring  to  light  some  principles 
which  we  could  hereafter  apply  to  the  study  of  other 
popular  errors.  But  the  obscurity  into  which  nearly 
all  these  enthusiasts  have  subsided  renders  the  ques 
tion  easier  to  ask  than  to  answer.  I  believe  it  would 
have  been  found  that  most  of  these  persons  were  of 
ardent  temperament  and  of  considerable  imagination, 
and  that  their  history  would  show  that  Perkinism  was 
not  the  first  nor  the  last  hobby-horse  they  rode  fu 
riously.  Many  of  them  may  very  probably  have  been 
persons  of  more  than  common  talent,  of  active  and  in 
genious  minds,  of  versatile  powers  and  various  acquire 
ments.  Such,  for  instance,  was  the  estimable  man  to 
whom  I  have  repeatedly  referred  as  a  warm  defender 
of  tractoration,  and  a  bitter  assailant  of  its  enemies. 
The  story  tells  itself  in  the  biographical  preface  to  his 
poem.  He  went  to  London  with  the  view  of  introdu- 


HOMOEOPATHY   AND   ITS   KINDRED   DELUSIONS.      29 

cing  a  hydraulic  machine,  which  he  and  his  Vermont 
friends  regarded  as  a  very  important  invention.  He 
found,  however,  that  the  machine  was  already  in  com 
mon  use  in  that  metropolis.  A  brother  Yankee,  then 
in  London,  had  started  the  project  of  a  mill,  which 
was  to  be  carried  by  the  water  of  the  Thames.  He 
was  sanguine  enough  to  purchase  one  fifth  of  this  con 
cern,  which  also  proved  a  failure.  At  about  the  same 
period  he  wrote  the  work  which  proved  the  great  ex 
citement  of  his  mind  upon  the  subject  of  the  transient 
folly  then  before  the  public.  Originally  a  lawyer,  he 
was  in  succession  a  mechanician,  a  poet,  and  an  editor, 
meeting  with  far  less  success  in  each  of  these  depart 
ments  than  usually  attends  men  of  less  varied  gifts, 
but  of  more  tranquil  and  phlegmatic  composition. 
But  who  is  ignorant  that  there  is  a  class  of  minds 
characterized  by  qualities  like  those  I  have  mentioned ; 
minds  with  many  bright  and  even  beautiful  traits ;  but 
aimless  and  fickle  as  the  butterfly ;  that  settle  upon 
every  gayly-colored  illusion  as  it  opens  into  flower,  and 
flutter  away  to  another  when  the  first  has  dropped  its 
leaves,  and  stands  naked  in  the  icy  air  of  truth ! 

Let  us  now  look  at  the  general  tenor  of  the  argu 
ments  addressed  by  believers  to  sceptics  and  opponents. 
Foremost  of  all,  emblazoned  at  the  head  of  every  col 
umn,  loudest  shouted  by  every  triumphant  disputant, 
held  up  as  paramount  to  all  other  considerations, 
stretched  like  an  impenetrable  shield  to  protect  the 
weakest  advocate  of  the  great  cause  against  the  weap 
ons  of  the  adversary,  was  that  omnipotent  monosylla 
ble  which  has  been  the  patrimony  of  cheats  and  the 
currency  of  dupes  from  time  immemorial,  —  Facts ! 
Facts  !  Facts  !  First  came  the  published  cases  of  the 
American  clergymen,  brigadier  -  generals,  almshouse 


30 


MEDICAL   ESSAYS. 


governors,  representatives,  attorneys,  and  esquires. 
Then  came  the  published  cases  of  the  surgeons  of 
Copenhagen.  Then  followed  reports  of  about  one  hun 
dred  and  fifty  cases  published  in  England,  "demon 
strating  the  efficacy  of  the  metallic  practice  in  a  va 
riety  of  complaints  both  upon  the  human  body  and  on 
horses,  etc."  But  the  progress  of  facts  in  Great  Brit 
ain  did  not  stop  here.  Let  those  who  rely  upon  the 
numbers  of  their  testimonials,  as  being  alone  sufficient 
to  prove  the  soundness  and  stability  of  a  medical  nov 
elty,  digest  the  following  from  the  report  of  the  Per- 
kinistic  Committee.  "  The  cases  published  [in  Great 
Britain]  amounted,  in  March  last,  the  date  of  Mr.  Per 
kins's  last  publication,  to  about  five  thousand.  Sup 
posing  that  not  more  than  one  cure  in  three  hundred 
which  the  Tractors  have  performed  has  been  published, 
and  the  proportion  is  probably  much  greater,  it  will 
be  seen  that  the  number,  to  March  last,  will  have  ex 
ceeded  one  million  five  hundred  thousand  !  " 

Next  in  order  after  the  appeal  to  what  were  called 
facts,  came  a  series  of  arguments,  which  have  been  so 
long  bruised  and  battered  round  in  the  cause  of  every 
doctrine  or  pretension,  new,  monstrous,  or  deliriously 
impossible,  that  each  of  them  is  as  odiously  familiar 
to  the  scientific  scholar  as  the  faces  of  so  many  old 
acquaintances,  among  the  less  reputable  classes,  to  the 
officers  of  police. 

No  doubt  many  of  my  hearers  will  recognize,  in  the 
following  passages,  arguments  they  may  have  heard 
brought  forward  with  triumphant  confidence  in  behalf 
of  some  doctrine  not  yet  extinct.  No  doubt  some  may 
have  honestly  thought  they  proved  something ;  may 
have  used  them  with  the  purpose  of  convincing  their 
friends,  or  of  silencing  the  opponents  of  their  favorite 


HOMCEOPATHY   AND   ITS   KINDRED   DELUSIONS.      31 

doctrine,  whatever  that  might  be.  But  any  train  of 
arguments  which  was  contrived  for  Perkinism,  which 
was  just  as  applicable  to  it  as  to  any  other  new  doctrine 
in  the  same  branch  of  science,  and  which  was  fully 
employed  against  its  adversaries  forty  years  since, 
might,  in  common  charity,  be  suffered  to  slumber  in 
the  grave  of  Perkinism.  Whether  or  not  the  follow 
ing  sentences,  taken  literally  from  the  work  of  Mr. 
Perkins,  were  the  originals  of  some  of  the  idle  propo 
sitions  we  hear  bandied  about  from  tune  to  time,  let 
those  who  listen  judge. 

The  following  is  the  test  assumed  for  the  new  prac 
tice  :  "  If  diseases  are  really  removed,  as  those  persons 
who  have  practised  extensively  with  the  Tractors  de-' 
clare,  it  should  seem  there  would  be  but  little  doubt  of 
their  being  generally  adopted ;  but  if  the  numerous 
reports  of  their  efficacy  which  have  been  published  are 
forgeries,  or  are  unfounded,  the  practice  ought  to  be 
crushed."  To  this  I  merely  add,  it  has  been  crushed. 

The  following  sentence  applies  to  that  d  priori 
judging  and  uncandid  class  of  individuals  who  buy 
their  dinners  without  tasting  all  the  food  there  is  in 
the  market.  "  On  all  discoveries  there  are  persons  who, 
without  descending  to  any  inquiry  into  the  truth,  pre 
tend  to  know,  as  it  were  by  intuition,  that  newly  as 
serted  facts  are  founded  in  the  grossest  errors.  These 
were  -those  who  knew  that  Harvey's  report  of  the  cir 
culation  of  the  blood  was  a  preposterous  and  ridiculous 
suggestion,  and  in  latter  [later]  days  there  were  others 
who  knew  that  Franklin  deserved  reproach  for  declar 
ing  that  points  were  preferable  to  balls  for  protecting 
buildings  from  lightning." 

Again:  "This  unwarrantable  mode  of  offering  as 
sertion  for  proof,  so  unauthorized  and  even  unprece- 


82  MEDICAL  ESSAYS. 

dented  except  in  the  condemnation  of  a  Galileo,  the 
persecution  of  a  Copernicus,  and  a  few  other  acts  of 
inquisitorial  authority,  in  the  times  of  ignorance  and 
superstition,  affords  but  a  lamentable  instance  of  one 
of  his  remarks,  that  this  is  far  from  being  the  Age  of 
Reason." 

"  The  most  valuable  medicines  in  the  Materia  Med- 
ica  act  on  principles  of  which  we  are  totally  ignorant. 
None  have  ever  yet  been  able  to  explain  how  opium 
produces  sleep,  or  how  bark  cures  intermittent  fevers  ; 
and  yet  few,  it  is  hoped,  will  be  so  absurd  as  to  desist 
from  the  use  of  these  important  articles  because  they 
know  nothing  of  the  principle  of  their  operations."  Or 
if  the  argument  is  preferred,  in  the  eloquent  language 
of  the  Perkinistic  poet :  — 

"  What  though  the  CAUSES  may  not  be  explained, 
Since  these  EFFECTS  are  duly  ascertained, 
Let  not  self-interest,  prejudice,  or  pride, 
Induce  mankind  to  set  the  means  aside  ; 
Means  which,  though  simple,  are  by  Heaven  designed 
T'  alleviate  the  woes  of  human  kind." 

This  course  of  argument  is  so  often  employed, 
that  it  deserves  to  be  expanded  a  little,  so  that  its 
length  and  breadth  may  be  fairly  seen.  A  series  of 
what  are  called  facts  is  brought  forward  to  prove 
some  very  improbable  doctrine.  It  is  objected  by  ju 
dicious  people,  or  such  as  have  devoted  themselves  to 
analogous  subjects,  that  these  assumed  facts  are  in 
direct  opposition  to  all  that  is  known  of  the  course  of 
nature,  that  the  universal  experience  of  the  past  af 
fords  a  powerful  presumption  against  their  truth,  and 
that  in  proportion  to  the  gravity  of  these  objections, 
should  be  the  number  and  competence  of  the  witnesses. 
The  answer  is  a  ready  one.  What  do  we  know  of  the 


HOMOEOPATHY  AND   ITS   KINDRED   DELUSIONS.      33 

mysteries  of  Nature  ?  Do  we  understand  the  intricate 
machinery  of  the  Universe  ?  When  to  this  is  added 
the  never-failing  quotation,  — 

44  There  are  more  things  in  heaven  and  earth,  Horatio, 
Than  are  dreamt  of  in  your  philosophy,"  — 

the  question  is  thought  to  be  finally  disposed  of. 

Take  the  case  of  astrology  as  an  example.  It  is  hi 
itself  strange  and  incredible  that  the  relations  of  the 
heavenly  bodies  to  each  other  at  a  given  moment  of 
time,  perhaps  half  a  century  ago,  should  have  any 
thing  to  do  with  my  success  or  misfortune  in  any 
undertaking  of  to-day.  But  what  right  have  I  to  say 
it  cannot  be  so  ?  Can  I  bind  the  sweet  influences  of 
Pleiades,  or  loose  the  bands  of  Orion  ?  I  do  not  know 
by  what  mighty  magic  the  planets  roll  in  their  fluid 
paths,  confined  to  circles  as  unchanging  as  if  they  were 
rings  of  steel,  nor  why  the  great  wave  of  ocean  fol 
lows  in  a  sleepless  round  upon  the  skirts  of  moonlight ; 
nor  can  I  say  from  any  certain  knowledge  that  the 
phases  of  the  heavenly  bodies,  or  even  the  falling  of 
the  leaves  of  the  forest,  or  the  manner  in  which  the 
sands  lie  upon  the  sea-shore,  may  not  be  knit  up  by 
invisible  threads  with  the  web  of  human  destiny. 
There  is  a  class  of  minds  much  more  ready  to  believe 
that  which  is  at  first  sight  incredible,  and  because  it 
is  incredible,  than  what  is  generally  thought  reason 
able.  Credo  quia  impossibile  est,  —  "I  believe,  be 
cause  it  is  impossible," — is  an  old  paradoxical  expres 
sion  which  might  be  literally  applied  to  this  tribe  of 
persons.  And  they  always  succeed  in  finding  some 
thing  marvellous,  to  call  out  the  exercise  of  their  ro 
bust  faith.  The  old  Cabalistic  teachers  maintained 
that  there  was  not  a  verse,  line,  word,  or  even  letter 
in  the  Bible  which  had  not  a  special  efficacy  either  to 


34  MEDICAL  ESSAYS. 

defend  the  person  who  rightly  employed  it,  or  to  injure 
his  enemies ;  always  provided  the  original  Hebrew  was 
made  use  of.  In  the  hands  of  modern  Cabalists  every 
substance,  no  matter  how  inert,  acquires  wonderful 
medicinal  virtues,  provided  it  be  used  in  a  proper  state 
of  purity  and  subdivision. 

I  have  already  mentioned  the  motives  attributed  by 
the  Perkinists  to  the  Medical  Profession,  as  prevent 
ing  its  members  from  receiving  the  new  but  unwel 
come  truths.  This  accusation  is  repeated  in  different 
forms  and  places,  as,  for  instance,  in  the  following  pas 
sage  :  — 

"  Will  the  medical  man  who  has  spent  much  money 
and  labor  in  the  pursuit  of  the  arcana  of  Physic,  and 
on  the  exercise  of  which  depends  his  support  in  life, 
proclaim  the  inefficacy  of  his  art,  and  recommend  a 
remedy  to  his  patient  which  the  most  unlettered  in 
society  can  employ  as  advantageously  as  himself  ? 
and  a  remedy,  too,  which,  unlike  the  drops,  the  pills, 
the  powders,  etc.,  of  the  Materia  Medica,  is  inconsum 
able,  and  ever  in  readiness  to  be  employed  in  success 
ive  diseases  ?  " 

As  usual  with  these  people,  much  indignation  was 
expressed  at  any  parallel  between  their  particular  doc 
trine  and  practice  and  those  of  their  exploded  prede 
cessors.  "The  motives,"  says  the  disinterested  Mr. 
Perkins,  "  which  must  have  impelled  to  this  attempt 
at  classing  the  METALLIC  PRACTICE  with  the  most 
paltry  of  empyrical  projects,  are  but  too  thinly  veiled 
to  escape  detection." 

To  all  these  arguments  was  added,  as  a  matter  of 
course,  an  appeal  to  the  feelings  of  the  benevolent  in 
behalf  of  suffering  humanity,  in  the  shape  of  a  notice 
that  the  poor  would  be  treated  gratis.  It  is  pretty 


HOMOEOPATHY  AND  ITS   KINDRED   DELUSIONS.      35 

well  understood  that  this  gratuitous  treatment  of  the 
poor  does  not  necessarily  imply  an  excess  of  benevo 
lence,  any  more  than  the  gratuitous  distribution  of  a 
trader's  shop-bills  is  an  evidence  of  remarkable  gen 
erosity  ;  in  short,  that  it  is  one  of  those  things  which 
honest  men  often  do  from  the  best  motives,  but  which 
rogues  and  impostors  never  fail  to  announce  as  one 
of  their  special  recommendations.  It  is  astonishing  to 
see  how  these  things  brighten  up  at  the  touch  of  Mr. 
Perkins's  poet :  — 

"  Ye  worthy,  honored,  philanthropic  few, 

The  muse  shall  weave  her  brightest  wreaths  for  you, 

Who  in  Humanity's  bland  cause  unite, 

Nor  heed  the  shaft  by  interest  aimed  or  spite ; 

Like  the  great  Pattern  of  Benevolence, 

Hygeia's  blessings  to  the  poor  dispense; 

And  though  opposed  by  folly's  servile  brood, 

ENJOY  THE  LUXURY  OF  DOING  GOOD." 

Having  thus  sketched  the  history  of  Perkinism  in 
its  days  of  prosperity ;  having  seen  how  it  sprung  into 
being,  and  by  what  means  it  maintained  its  influence, 
it  only  remains  to  tell  the  brief  story  of  its  discom 
fiture  and  final  downfall.  The  vast  majority  of  the 
sensible  part  of  the  medical  profession  were  contented, 
so  far  as  we  can  judge,  to  let  it  die  out  of  itself.  It 
was  in  vain  that  the  advocates  of  this  invaluable  dis 
covery  exclaimed  over  their  perverse  and  interested  ob 
stinacy, —  in  vain  that  they  called  up  the  injured 
ghosts  of  Harvey,  Galileo,  and  Copernicus  to  shame 
that  unbelieving  generation ;  the  Baillies  and  the  Heb- 
erdens,  —  men  whose  names  have  come  down  to  us 
as  synonymous  with  honor  and  wisdom,  —  bore  their 
reproaches  in  meek  silence,  and  left  them  unanswered 
to  their  fate.  There  were  some  others,  however,  who, 


86  MEDICAL  ESSAYS. 

believing  the  public  to  labor  under  a  delusion,  thought 
it  worth  while  to  see  whether  the  charm  would  be 
broken  by  an  open  trial  of  its  virtue,  as  compared 
with  that  of  some  less  hallowed  formula.  It  must  be 
remembered  that  a  peculiar  value  was  attached  to  the 
Metallic  Tractors,  as  made  and  patented  by  Mr.  Per 
kins.  Dr.  Haygarth,  of  Bath,  performed  various 
experiments  upon  patients  afflicted  with  different  com 
plaints,  —  the  patients  supposing  that  the  real  five- 
guinea  Tractors  were  employed.  Strange  to  relate, 
he  obtained  equally  wonderful  effects  with  Tractors  of 
lead  and  of  wood;  with  nails,  pieces  of  bone,  slate 
pencil,  and  tobacco-pipe.  Dr.  Alderson  employed 
sham  Tractors  made  of  wood,  and  produced  such  ef 
fects  upon  five  patients  that  they  returned  solemn 
thanks  in  church  for  their  cures.  A  single  specimen 
of  these  cases  may  stand  for  all  of  them.  Ann  Hill 
had  suffered  for  some  months  from  pain  in  the  right 
arm  and  shoulder.  The  Tractors  (wooden  ones)  were 
applied,  and  in  the  space  of  five  minutes  she  expressed 
herself  relieved  in  the  following  apostrophe:  "Bless 
me !  why,  who  could  have  thought  it,  that  them  little 
things  could  pull  the  pain  from  one.  Well,  to  be  sure, 
the  longer  one  lives,  the  more  one  sees ;  ah,  dear !  " 

These  experiments  did  not  result  in  the  immediate 
extinction  of  Perkinism.  Doubtless  they  were  a  great 
comfort  to  many  obstinate  unbelievers,  and  helped  to 
settle  some  sceptical  minds ;  but  for  the  real  Perkinis- 
tic  enthusiasts,  it  may  be  questioned  whether  they 
would  at  that  time  have  changed  their  opinion  though 
one  had  risen  from  the  dead  to  assure  them  that  it  was 
an  error.  It  perished  without  violence,  by  an  easy  and 
natural  process.  Like  the  famous  toy  of  Mongolfier, 
it  rose  by  means  of  heated  air,  —  the  fevered  breath  of 


HOMCEOPATHY   AND   ITS   KINDRED   DELUSIONS.       37 

enthusiastic  ignorance,  —  and  when  this  grew  cool,  as 
it  always  does  in  a  little  while,  it  collapsed  and  fell. 

And  now,  on  reviewing  the  whole  subject,  how  shall 
we  account  for  the  extraordinary  prevalence  of  the  be 
lief  in  Perkinism  among  a  portion  of  what  is  supposed 
to  be  the  thinking  part  of  the  community  ? 

Could  the  cures  have  been  real  ones,  produced  by 
the  principle  of  ANIMAL  MAGNETISM  ?  To  this  it  may 
be  answered  that  the  Perkinists  ridiculed  the  idea  of 
approximating  Mesmer  and  the  founder  of  their  own 
doctrine,  that  nothing  like  the  somnambulic  condition 
seems  to  have  followed  the  use  of  the  Tractors,  and 
that  neither  the  exertion  of  the  will  nor  the  powers  of 
the  individual  who  operated  seem  to  have  been  consid 
ered  of  any  consequence.  Besides,  the  absolute  neglect 
into  which  the  Tractors  soon  declined  is  good  evidence 
that  they  were  incapable  of  affording  any  considerable 
and  permanent  relief  in  the  complaints  for  the  cure  of 
which  they  were  applied. 

Of  course  a  large  number  of  apparent  cures  were 
due  solely  to  nature ;  which  is  true  under  every  form 
of  treatment,  orthodox  or  empirical.  Of  course  many 
persons  experienced  at  least  temporary  relief  from  the 
strong  impression  made  upon  their  minds  by  this  novel 
and  marvellous  method  of  treatment. 

Many,  again,  influenced  by  the  sanguine  hopes  of 
those  about  them,  like  dying  people,  who  often  say 
sincerely,  from  day  to  day,  that  they  are  getting  bet 
ter,  cheated  themselves  into  a  false  and  short-lived  be 
lief  that  they  were  cured ;  and  as  happens  in  such 
cases,  the  public  never  knew  more  than  the  first  half 
of  the  story. 

When  it  was  said  to  the  Perkinists,  that  whatever 


38  MEDICAL   ESSAYS, 

effects  they  produced  were  merely  through  the  imagi 
nation,  they  declared  (like  the  advocates  of  the  ROYAL 
TOUCH  and  the  UNGUENTUM  AEMARIUM)  that  this 
explanation  was  sufficiently  disproved  by  the  fact  of 
numerous  and  successful  cures  which  had  been  wit 
nessed  in  infants  and  brute  animals.  Dr.  Haygarth 
replied  to  this,  that  "  in  these  cases  it  is  not  the  Pa 
tient,  but  the  Observer,  who  is  deceived  by  his  own 
imagination,"  and  that  such  may  be  the  fact,  we  have 
seen  in  the  case  of  the  good  lady  who  thought  she  had 
conjured  away  the  spot  from  her  friend's  countenance, 
when  it  remained  just  as  before. 

As  to  the  motives  of  the  inventor  and  vender  of  the 
Tractors,  the  facts  must  be  allowed  to  speak  for  them 
selves.  But  when  two  little  bits  of  brass  and  iron  are 
patented,  as  an  invention,  as  the  result  of  numerous 
experiments,  when  people  are  led,  or  even  allowed,  to 
infer  that  they  are  a  peculiar  compound,  when  they  are 
artfully  associated  with  a  new  and  brilliant  discovery 
(which  then  happened  to  be  Galvanism),  when  they 
are  sold  at  many  hundred  times  their  value,  and  the 
seller  prints  his  opinion  that  a  Hospital  will  suffer  in 
convenience  "unless  it  possesses  many  sets  of  the 
Tractors,  and  these  placed  in  the  hands  of  the  patients 
to  practise  on  each  other,"  one  cannot  but  suspect  that 
they  were  contrived  in  the  neighborhood  of  a  wooden 
nutmeg  factory ;  that  legs  of  ham  in  that  region  are 
not  made  of  the  best  mahogany ;  and  that  such  as  buy 
their  cucumber  seed  in  that  vicinity  have  to  wait  for 
the  fruit  as  long  as  the  Indians  for  their  crop  of  gun 
powder. 

The  succeeding  lecture  will  be  devoted  to  an  exams, 
Ination  of  the  doctrines  of  Samuel  Hahnemann  and 


HOMOEOPATHY   AND   ITS   KINDRED   DELUSIONS.      39 

his  disciples ;  doctrines  which  some  consider  new  and 
others  old ;  the  common  title  of  which  is  variously 
known  as  H6-mo3opathy,  Homoe-6p-athy,  Homo2o-path-y, 
or  Hom'pathy,  and  the  claims  of  which  are  considered 
by  some  as  infinitely  important,  and  by  many  as  im 
measurably  ridiculous. 

I  wish  to  state,  for  the  sake  of  any  who  may  be  in 
terested  in  the  subject,  that  I  shall  treat  it,  not  by 
ridicule,  but  by  argument ;  perhaps  with  great  free 
dom,  but  with  good  temper  and  in  peaceable  language ; 
with  very  little  hope  of  reclaiming  converts,  with  no 
desire  of  making  enemies,  but  with  a  firm  belief  that 
its  pretensions  and  assertions  cannot  stand  before  a 
single  hour  of  calm  investigation. 


II. 

It  may  be  thought  that  a  direct  attack  upon  the 
pretensions  of  HOMEOPATHY  is  an  uncalled-for  aggres 
sion  upon  an  unoffending  doctrine  and  its  peaceful 
advocates. 

But  a  little  inquiry  will  show  that  it  has  long  as 
sumed  so  hostile  a  position  with  respect  to  the  Medical 
Profession,  that  any  trouble  I,  or  any  other  member  of 
that  profession,  may  choose  to  bestow  upon  it  may  be 
considered  merely  as  a  matter  of  self-defence.  It  began 
with  an  attempt  to  show  the  insignificance  of  all  existing 
medical  knowledge.  It  not  only  laid  claim  to  wonder 
ful  powers  of  its  own,  but  it  declared  the  common 
practice  to  be  attended  with  the  most  positively  inju 
rious  effects,  that  by  it  acute  diseases  are  aggravated, 
and  chronic  diseases  rendered  incurable.  It  has  at 
various  times  brought  forward  collections  of  figures 


40  MEDICAL  ESSAYS. 

having  the  air  of  statistical  documents,  pretending  to 
show  a  great  proportional  mortality  among  the  patienta 
of  the  Medical  Profession,  as  compared  with  those 
treated  according  to  its  own  rules.  Not  contented 
with  choosing  a  name  of  classical  origin  for  itself,  it 
invented  one  for  the  whole  community  of  innocent 
physicians,  assuring  them,  to  their  great  surprise,  that 
they  were  all  ALLOPATHISTS,  whether  they  knew  it  or 
not,  and  including  all  the  illustrious  masters  of  the 
past,  from  Hippocrates  down  to  Hunter,  under  the 
same  gratuitous  title.  The  line,  then,  has  been  drawn 
by  the  champions  of  the  new  doctrine ;  they  have  lifted 
the  lance,  they  have  sounded  the  charge,  and  are  re 
sponsible  for  any  little  skirmishing  which  may  happen. 

But,  independently  of  any  such  grounds  of  active 
resistance,  the  subject  involves  interests  so  dispropor- 
tioned  to  its  intrinsic  claims,  that  it  is  no  more  than 
an  act  of  humanity  to  give  it  a  public  examination.  If 
the  new  doctrine  is  not  truth,  it  is  a  dangerous,  a 
deadly  error.  If  it  is  a  mere  illusion,  and  acquires  the 
same  degree  of  influence  that  we  have  often  seen  ob 
tained  by  other  illusions,  there  is  not  one  of  my 
audience  who  may  not  have  occasion  to  deplore  the 
fatal  credulity  which  listened  to  its  promises. 

I  shall  therefore  undertake  a  sober  examination  of 
its  principles,  its  facts,  and  some  points  of  its  history. 
The  limited  time  at  my  disposal  requires  me  to  con 
dense  as  much  as  possible  what  I  have  to  say,  but  I 
shall  endeavor  to  be  plain  and  direct  in  expressing  it. 
Not  one  statement  shall  be  made  which  cannot  be  sup 
ported  by  unimpeachable  reference :  not  one  word 
shall  be  uttered  which  I  am  not  as  willing  to  print  as 
to  speak.  I  have  no  quibbles  to  utter,  and  I  shall 
stoop  to  answer  none  ;  but,  with  full  faith  in  the  suffi- 


HOM(EOPATHT   AND   ITS   KINDRED   DELUSIONS.      41 

oiency  of  a  plain  statement  of  facts  and  reasons,  1  sub 
mit  the  subject  to  the  discernment  of  my  audience. 

The  question  may  be  asked  in  the  outset,  —  Have 
you  submitted  the  doctrines  you  are  professing  to 
examine  to  the  test  of  long-repeated  and  careful  ex 
periment  ;  have  you  tried  to  see  whether  they  were 
true  or  not  ?  To  this  I  answer,  that  it  is  abundantly 
evident,  from  what  has  often  happened,  that  it  would 
be  of  no  manner  of  use  for  me  to  allege  the  results  of 
any  experiments  I  might  have  instituted.  Again  and 
again  have  the  most  explicit  statements  been  made  by 
the  most  competent  persons  of  the  utter  failure  of  all 
their  trials,  and  there  were  the  same  abundant  explana 
tions  offered  as  used  to  be  for  the  Unguentum  Arma- 
rium  and  the  Metallic  Tractors.  I  could  by  no  possibil 
ity  perform  any  experiments  the  result  of  which  could 
not  be  easily  explained  away  so  as  to  be  of  no  conclu 
sive  significance.  Besides,  as  arguments  in  favor  of 
Homoeopathy  are  constantly  addressed  to  the  public  in 
journals,  pamphlets,  and  even  lectures,  by  inexperienced 
dilettanti,  the  same  channel  must  be  open  to  all  its 
opponents. 

It  is  necessary,  for  the  sake  of  those  to  whom  the 
whole  subject  may  be  new,  to  give  in  the  smallest 
possible  compass  the  substance  of  the  Homoaopathic 
Doctrine.  Samuel  Hahnemann,  its  founder,  is  a 
German  physician,  now  living  in  Paris,"  at  the  age  of 
eighty-seven  years.  In  1796  he  published  the  first 
paper  containing  his  peculiar  notions;  in  1805  his 
first  work  on  the  subject ;  in  1810  his  somewhat 
famous  "  Organon  of  the  Healing  Art ; "  the  next  year 
what  he  called  the  "  Pure  Materia  Medica  ; "  and  in 
0  Hahnemann  died  in  1843. 


42  MEDICAL   ESSAYS. 

1828  his  last  work,  the  "  Treatise  on  Chronic  Dis 
eases."  He  has  therefore  been  writing  at  intervals  on 
his  favorite  subject  for  nearly  half  a  century. 

The  one  great  doctrine  which  constitutes  the  basis 
of  Homosopathy  as  a  system  is  expressed  by  the  Latin 
aphorism, 

"SlMILIA   SIMILIBUS   CURANTUR," 

or  like  cures  like,  that  is,  diseases  are  cured  by  agents 
capable  of  producing  symptoms  resembling  those 
found  in  the  disease  under  treatment.  A  disease  for 
Hahnemann  consists  essentially  in  a  group  of  symp 
toms.  The  proper  medicine  for  any  disease  is  the  one 
which  is  capable  of  producing  a  similar  group  of  symp 
toms  when  given  to  a  healthy  person. 

It  is  of  course  necessary  to  know  what  are  the 
trains  of  symptoms  excited  by  different  substances, 
when  administered  to  persons  in  health,  if  any  such 
can  be  shown  to  exist.  Hahnemann  and  his  disciples 
give  catalogues  of  the  symptoms  which  they  affirm 
were  produced  upon  themselves  or  others  by  a  large 
number  of  drugs  which  they  submitted  to  experi 
ment. 

The  second  great  fact  which  Hahnemann  professes 
to  have  established  is  the  efficacy  of  medicinal  sub 
stances  reduced  to  a  wonderful  degree  of  minuteness 
or  dilution.  The  following  account  of  his  mode  of 
preparing  his  medicines  is  from  his  work  on  Chronic 
Diseases,  which  has  not,  I  believe,  yet  been  translated 
into  English.  A  grain  of  the  substance,  if  it  is  solid, 
a  drop  if  it  is  liquid,  is  to  be  added  to  about  a  third 
part  of  one  hundred  grains  of  sugar  of  milk  in  an 
unglazed  porcelain  capsule  which  has  had  the  polish 
removed  from  the  lower  part  of  its  cavity  by  rubbing 


HOMCEOPATHY   AND   ITS   KINDKED   DELUSIONS.      43 

it  with  wet  sand ;  they  are  to  be  mingled  for  an  in 
stant  with  a  bone  or  horn  spatula,  and  then  rubbed 
together  for  six  minutes ;  then  the  mass  is  to  be 
scraped  together  from  the  mortar  and  pestle,  which 
is  to  take  four  minutes ;  then  to  be  again  rubbed  for 
six  minutes.  Four  minutes  are  then  to  be  devoted 
to  scraping  the  powder  into  a  heap,  and  the  second 
third  of  the  hundred  grains  of  sugar  of  milk  to  be 
added.  Then  they  are  to  be  stirred  an  instant  and 
rubbed  six  minutes,  —  again  to  be  scraped  together 
four  minutes  and  forcibly  rubbed  six;  once  more 
scraped  together  for  four  minutes,  when  the  last 
third  of  the  hundred  grains  of  sugar  of  milk  is  to 
be  added  and  mingled  by  stirring  with  the  spatula , 
six  minutes  of  forcible  rubbing,  four  of  scraping  to 
gether,  and  six  more  (positively  the  last  six)  of  rub 
bing,  finish  this  part  of  the  process. 

Every  grain  of  this  powder  contains  the  hundredth 
of  a  grain  of  the  medicinal  substance  mingled  with 
the  sugar  of  milk.  If,  therefore,  a  grain  of  the  pow 
der  just  prepared  is  mingled  with  another  hundred 
grains  of  sugar  of  milk,  and  the  process  just  described 
repeated,  we  shall  have  a  powder  of  which  every 
grain  contains  the  hundredth  of  the  hundredth,  or 
the  ten  thousandth  part  of  a  grain  of  the  medicinal 
substance.  Repeat  the  same  process  with  the  same 
quantity  of  fresh  sugar  of  milk,  and  every  grain  of 
your  powder  will  contain  the  millionth  of  a  grain  of 
the  medicinal  substance.  When  the  powder  is  of  this 
strength,  it  is  ready  to  employ  in  the  further  solutions 
and  dilutions  to  be  made  use  of  in  practice. 

A  grain  of  the  powder  is  to  be  taken,  a  hundred 
drops  of  alcohol  are  to  be  poured  on  it,  the  vial  is  to 
be  slowly  turned  for  a  few  minutes,  until  the  powder 


44  MEDICAL  ESSAYS. 

is  dissolved,  and  two  shakes  are  to  be  given  to  it.  On 
this  point  I  will  quote  Hahnemann's  own  words.  "  A 
long  experience  and  multiplied  observations  upon  the 
sick  lead  me  within  the  last  few  years  to  prefer  giving 
only  two  shakes  to  medicinal  liquids,  whereas  I  for 
merly  used  to  give  ten."  The  process  of  dilution  is 
carried  on  in  the  same  way  as  the  attenuation  of  the 
powder  was  done ;  each  successive  dilution  with  alco 
hol  reducing  the  medicine  to  a  hundredth  part  of  the 
quantity  of  that  which  preceded  it.  In  this  way  the 
dilution  of  the  original  millionth  of  a  grain  of  medi 
cine  contained  in » the  grain  of  powder  operated  on  is 
carried  successively  to  the  billionth,  trillionth,  quad- 
rillionth,  quintillionth,  and  very  often  much  higher 
fractional  divisions.  A  dose  of  any  of  these  medi 
cines  is  a  minute  fraction  of  a  drop,  obtained  by 
moistening  with  them  one  or  more  little  globules  of 
sugar,  of  which  Hahnemann  says  it  takes  about  two 
hundred  to  weigh  a  grain. 

As  an  instance  of  the  strength  of  the  medicines 
prescribed  by  Hahnemann,  I  will  mention  carbonate 
of  lime.  He  does  not  employ  common  chalk,  but  pre 
fers  a  little  portion  of  the  friable  part  of  an  oyster- 
shell.  Of  this  substance,  carried  to  the  sextillionth 
degree,  so  much  as  one  or  two  globules  of  the  size 
mentioned  can  convey  is  a  common  dose.  But  for 
persons  of  very  delicate  nerves  it  is  proper  that  the 
dilution  should  be  carried  to  the  decillionth  degree. 
That  is,  an  important  medicinal  effect  is  to  be  ex 
pected  from  the  two  hundredth  or  hundredth  part  of 
the  millionth  of  the  millionth  of  the  millionth  of  the 
millionth  of  the  millionth  of  the  millionth  of  the 
millionth  of  the  millionth  of  the  millionth  of  the 
millionth  of  a  grain  of  oyster-shell.  This  is  only  the 


HOMCEOPATHY   AND   ITS   KINDRED   DELUSIONS.      45 

tenth  degree  of  potency,  but  some  of  his  disciples  pro 
fess  to  have  obtained  palpable  effects  from  much  higher 
dilutions." 

The  third  great  doctrine  of  Halmemann  is  the  fol 
lowing.  Seven  eighths  at  least  of  all  chronic  diseases 
are  produced  by  the  existence  in  the  system  of  that  in 
fectious  disorder  known  in  the  language  of  science  by 
the  appellation  of  PSORA,  but  to  the  less  refined  por 
tion  of  the  community  by  the  name  of  ITCH.  In  the 
words  of  Hahnemann's  "  Organon,"  "  This  Psora  is  the 
sole  true  and  fundamental  cause  that  produces  all  the 
other  countless  forms  of  disease,  which,  under  the 
names  of  nervous  debility,  hysteria,  hypochondriasis, 
insanity,  melancholy,  idiocy,  madness,  epilepsy,  and 
spasms  of  all  kinds,  softening  of  the  bones,  or  rickets, 
scoliosis  and  cyphosis,  caries,  cancer,  fungus  haema- 
todes,  gout,  —  yellow  jaundice  and  cyanosis,  dropsy,  — 

•  The  degrees  of  DILUTION  must  not  be  confounded  with 
those  of  POTENCY.  Their  relations  may  be  seen  by  this 
table  :  — 

1st  dilution,  —  One  hundredth  of  a  drop  or  grain. 
2d        "  One  ten  thousandth. 

3d         "  One  millionth,  —  marked   L 

4th       "  One  hundred  millionth. 

5th       "  One  ten  thousand  millionth. 

6th       "  One    million  millionth,   or  one  billionth,-* 

marked  II. 


7th 
8th 
9th 

10th 
llth 
12th 


One  hundred  billionth. 

One  ten  thousand  billionth. 

One  million    billionth,    or   one    trilliontb,  • 

marked  III. 
One  hundred  trillionth. 
One  ten  thousand  trillionth. 
One  million  trillionth,  or  one  quadrillionth, 


marked  IV.,  —  and  so  on  indefinitely 
The  large  figures  denote  the  degrees  of  POTENCY. 


46  MEDICAL  ESSAYS. 

gastralgia,  epistaxis,  haemoptysis,  —  asthma  and  sup. 
puration  of  the  lungs,  —  megrim,  deafness,  cataract 
and  amaurosis,  —  paralysis,  loss  of  sense,  pains  of 
every  kind,  etc.,  appear  in  our  pathology  as  so  many 
peculiar,  distinct,  and  independent  diseases." 

For  the  last  three  centuries,  if  the  same  authority 
may  be  trusted,  under  the  influence  of  the  more  re- 
fined  personal  habits  which  have  prevailed,  and  the 
application  of  various  external  remedies  which  repel 
the  affection  from  the  skin,  Psora  has  revealed  itself 
in  these  numerous  forms  of  internal  disease,  instead  of 
appearing,  as  in  former  periods,  under  the  aspect  of 
an  external  malady. 

These  are  the  three  cardinal  doctrines  of  Hahne- 
mann,  as  laid  down  in  those  standard  works  of  Ho- 
moaopathy,  the  "  Organon "  and  the  "  Treatise  on 
Chronic  Diseases." 

Several  other  principles  may  be  added,  upon  all  of 
which  he  insists  with  great  force,  and  which  are  very 
generally  received  by  his  disciples. 

1.  Very  little  power  is  allowed  to  the  curative  ef 
forts  of  nature.     Hahnemann  goes  so  far  as  to  say 
that  no  one  has  ever  seen  the  simple  efforts  of  nature 
effect  the  durable  recovery  of  a  patient  from  a  chronic 
disease.     In  general,  the  Homoaopathist  calls  every  re 
covery  which  happens  under  his  treatment  a  cure. 

2.  Every  medicinal  substance  must  be  administered 
in  a  state  of  the  most  perfect  purity,  and  uncombined 
with  any  other.     The  union  of  several  remedies  in  a 
single  prescription  destroys  its  utility,  and,  according 
to  the  "  Organon,"  frequently  adds  a  new  disease. 

3.  A  large  number  of  substances  commonly  thought 
to  be  inert  develop  great  medicinal  powers  when  pre 
pared  in  the  manner  already  described ;  and  a  great 


HOMOEOPATHY   AND   ITS   KINDRED   DELUSIONS.      47 

proportion  of  them  are  ascertained  to  have  specific  an- 
tidotes  in  case  their  excessive  effects  require  to  be  neu 
tralized. 

4.  Diseases  should  be  recognized,  as  far  as  possible, 
not  by  any  of  the  common  names  imposed  upon  them, 
as  fever  or  epilepsy,  but  as  individual  collections  of 
symptoms,  each  of  which  differs  from  every  other  col 
lection. 

5.  The  symptoms  of   any  complaint   must  be   de 
scribed  with  the  most  minute  exactness,  and  so  far  as 
possible  in  the  patient's  own  words.     To  illustrate  the 
kind  of  circumstances  the  patient  is  expected  to  record, 
I  will  mention  one  or  two  from  the  313th  page  of  the 
"Treatise  on  Chronic  Diseases,"  —  being  the  first  one 
at  which  I  opened  accidentally. 

"After  dinner,  disposition  to  sleep;  the  patient 
winks." 

"  After  dinner,  prostration  and  feeling  of  weakness 
(nine  days  after  taking  the  remedy)." 

This  remedy  was  that  same  oyster-shell  which  is  to 
be  prescribed  in  fractions  of  the  sextillionth  or  decil- 
lionth  degree.  According  to  Hahnemann,  the  action 
of  a  single  dose  of  the  size  mentioned  does  not  fully 
display  itself  in  some  cases  until  twenty-four  or  even 
thirty  days  after  it  is  taken,  and  in  such  instances  has 
not  exhausted  its  good  effects  until  towards  the  for 
tieth  or  fiftieth  day,  —  before  which  time  it  would  be 
absurd  and  injurious  to  administer  a  new  remedy. 

So  much  for  the  doctrines  of  Hahnemann,  which 
have  been  stated  without  comment,  or  exaggeration  of 
any  of  their  features,  very  much  as  any  adherent  of 
his  opinions  might  have  stated  them,  if  obliged  to 
compress  them  into  so  narrow  a  space. 


48  MEDICAL  ESSAYS. 

Does  Hahnemann  himself  represent  Homoeopathy 
as  it  now  exists  ?  He  certainly  ought  to  be  its  best 
representative,  after  having  created  it,  and  devoted  his 
life  to  it  for  half  a  century.  He  is  spoken  of  as  the 
great  physician  of  the  time,  in  most,  if  not  all  Homoe 
opathic  works.  If  he  is  not  authority  on  the  subject 
of  his  own  doctrines,  who  is  ?  So  far  as  I  am  aware, 
not  one  tangible  discovery  in  the  so-called  science  has 
ever  been  ascribed  to  any  other  observer ;  at  least,  no 
general  principle  or  law,  of  consequence  enough  to 
claim  any  prominence  in  Homoeopathic  works,  has  ever 
been  pretended  to  have  originated  with  any  of  his  il 
lustrious  disciples.  He  is  one  of  the  only  two  Homoe 
opathic  writers  with  whom,  as  I  shall  mention,  the 
Paris  publisher  will  have  anything  to  do  upon  his  own 
account.  The  other  is  Jahr,  whose  Manual  is  little 
more  than  a  catalogue  of  symptoms  and  remedies.  If 
any  persons  choose  to  reject  Hahnemann  as  not  in  the 
main  representing  Homoeopathy,  if  they  strike  at  his 
authority,  if  they  wink  out  of  sight  his  deliberate  and 
formally  announced  results,  it  is  an  act  of  suicidal 
rashness ;  for  upon  his  sagacity  and  powers  of  obser 
vation,  and  experience,  as  embodied  in  his  works,  and 
especially  in  his  Materia  Medica,  repose  the  founda 
tions  of  Homoeopathy  as  a  practical  system. 

So  far  as  I  can  learn  from  the  conflicting  statements 
made  upon  the  subject,  the  following  is  the  present 
condition  of  belief. 

1.  All  of  any  note  agree  that  the  law  Similia  si- 
milibus  is  the  only  fundamental  principle  in  medicine. 
Of  course  if  any  man  does  not  agree  to  this  the  name 
Homoeopathist  can  no  longer  be  applied  to  him  with 
propriety. 

2.  The  belief  in  and  employment  of  the  infinites!- 


HOMOEOPATHY   AND   ITS   KINDRED   DELUSIONS.      49 

mal  doses  is  general,  and  in  some  places  universal, 
among  the  advocates  of  Homoeopathy ;  but  a  distinct 
movement  has  been  made  in  Germany  to  get  rid  of 
any  restriction  to  the  use  of  these  doses,  and  to  em 
ploy  medicines  with  the  same  license  as  other  prac 
titioners. 

3.  The  doctrine  of  the  origin  of  most  chronic  dis 
eases  in  Psora,  notwithstanding  Hahnemann  says  it 
cost  him  twelve  years  of  study  and  research  to  estab 
lish  the  fact  and  its  practical  consequences,  has  met 
with  great  neglect  and  even  opposition  from  very  many 
of  his  own  disciples. 

It  is  true,  notwithstanding,  that,  throughout  most  of 
their  writings  which  I  have  seen,  there  runs  a  prevail 
ing  tone  of  great  deference  to  Hahnemann's  opinions, 
a  constant  reference  to  his  authority,  a  general  agree 
ment  with  the  minor  points  of  his  belief,  and  a  pre 
tence  of  harmonious  union  in  a  common  faith.* 

Many  persons,  and  most  physicians  and  scientific 
men,  would  be  satisfied  with  the  statement  of  these 
doctrines,  and  examine  them  no  further.  They  would 
consider  it  vastly  more  probable  that  any  observer  in 
so  fallacious  and  difficult  a  field  of  inquiry  as  medicine 
had  been  led  into  error,  or  walked  into  it  of  his  own 
accord,  than  that  such  numerous  and  extraordinary 
facts  had  really  just  come  to  light.  They  would  feel 
a  right  to  exercise  the  same  obduracy  towards  them  as 
the  French  Institute  is  in  the  habit  of  displaying  when 
memoirs  or  models  are  offered  to  it  relating  to  the 
squaring  of  the  circle  or  perpetual  motion  ;  which  it  is 

•  Those  who  will  take  the  trouble  to  look  over  Hull's  Trans 
lation  of  Jahr's  Manual  may  observe  how  little  comparative 
space  is  given  to  remedies  resting  upon  any  other  authority  than 
that  of  Hahnemann. 


50  MEDICAL  ESSAYS. 

the  rule  to  pass  over  without  notice.  They  would  feel 
as  astronomers  and  natural  philosophers  must  have  felt 
when,  some  half  a  dozen  years  ago,  an  unknown  man 
came  forward,  and  asked  for  an  opportunity  to  demon 
strate  to  Arago  and  his  colleagues  that  the  moon  and 
planets  were  at  a  distance  of  a  little  more  than  a  hun 
dred  miles  from  the  earth.  And  so  they  would  not 
even  look  into  Homoaopathy,  though  all  its  advocates 
should  exclaim  in  the  words  of  Mr.  Benjamin  Doug 
lass  Perkins,  vender  of  the  Metallic  Tractors,  that  "  On 
all  discoveries  there  are  persons  who,  without  descend 
ing  to  any  inquiry  into  the  truth,  pretend  to  know,  as 
it  were  by  intuition,  that  newly  asserted  facts  are 
founded  in  the  grossest  errors."  And  they  would  lay 
their  heads  upon  their  pillows  with  a  perfectly  clear 
conscience,  although  they  were  assured  that  they  were 
behaving  in  the  same  way  that  people  of  old  did  to. 
wards  Harvey,  Galileo,  and  Copernicus,  the  identical 
great  names  which  were  invoked  by  Mr.  Benjamin 
Douglass  Perkins. 

But  experience  has  shown  that  the  character  of 
these  assertions  is  not  sufficient  to  deter  many  from 
examining  their  claims  to  belief.  I  therefore  lean  but 
very  slightly  on  the  extravagance  and  extreme  appar 
ent  singularity  of  their  pretensions.  I  might  have 
omitted  them,  but  on  the  whole  it  seemed  more  just 
to  the  claims  of  my  argument  to  suggest  the  vast  com 
plication  of  improbabilities  involved  in  the  statements 
enumerated.  Every  one  must  of  course  judge  for 
himself  as  to  the  weight  of  these  objections,  which  are 
by  no  means  brought  forward  as  a  proof  of  the  ex 
travagance  of  Homoaopathy,  but  simply  as  entitled  to 
a  brief  consideration  before  the  facts  of  the  case  are 
submitted  to  our  scrutiny. 


HOMOEOPATHY   AND   ITS   KINDRED   DELUSIONS.      51 

The  three  great  asserted  discoveries  of  Hahnemann 
are  entirely  unconnected  with  and  independent  of  each 
other.  Were  there  any  natural  relation  between  them 
it  would  seem  probable  enough  that  the  discovery  of 
the  first  would  have  led  to  that  of  the  others.  But 
assuming  it  to  be  a  fact  that  diseases  are  cured  by 
remedies  capable  of  producing  symptoms  like  their 
own,  no  manifest  relation  exists  between  this  fact  and 
the  next  assertion,  namely,  the  power  of  the  infinites 
imal  doses.  And  allowing  both  these  to  be  true, 
neither  has  the  remotest  affinity  to  the  third  new  doc 
trine,  that  which  declares  seven  eighths  of  all  chronic 
diseases  to  be  owing  to  Psora. 

This  want  of  any  obvious  relation  between  Hahne- 
mann's  three  cardinal  doctrines  appears  to  be  self- 
evident  upon  inspection.  But  if,  as  is  often  true  with 
his  disciples,  they  prefer  the  authority  of  one  of 
their  own  number,  I  will  refer  them  to  Dr.  Trinks's 
paper  on  the  present  state  of  Homoeopathy  in  Europe, 
with  which,  of  course,  they  are  familiar,  as  his  name 
is  mentioned  as  one  of  the  most  prominent  champions 
of  their  faith,  in  their  American  official  organ.  It 
would  be  a  fact  without  a  parallel  in  the  history,  not 
merely  of  medicine,  but  of  science,  that  three  such 
unconnected  and  astonishing  discoveries,  each  of  them 
a  complete  revolution  of  all  that  ages  of  the  most  va 
ried  experience  had  been  taught  to  believe,  should 
spring  full  formed  from  the  brain  of  a  single  indi 
vidual. 

Let  us  look  a  moment  at  the  first  of  his  doctrines. 
Improbable  though  it  may  seem  to  some,  there  is  no 
essential  absurdity  involved  in  the  proposition  that 
diseases  yield  to  remedies  capable  of  producing  like 
symptoms.  There  are,  on  the  other  hand,  some  anal- 


52  MEDICAL   ESSAYS. 

ogies  which  lend  a  degree  of  plausibility  to  the  state 
ment.  There  are  well-ascertained  facts,  known  from 
the  earliest  periods  of  medicine,  showing  that,  under 
certain  circumstances,  the  very  medicine  which,  from 
its  known  effects,  one  would  expect  to  aggravate  the 
disease,  may  contribute  to  its  relief.  I  may  be  per 
mitted  to  allude,  in  the  most  general  way,  to  the  case 
in  which  the  spontaneous  efforts  of  an  overtasked 
stomach  are  quieted  by  the  agency  of  a  drug  which 
that  organ  refuses  to  entertain  upon  any  terms.  But 
that  every  cure  ever  performed  by  medicine  should 
have  been  founded  upon  this  principle,  although  with 
out  the  knowledge  of  a  physician ;  that  the  Homoeo 
pathic  axiom  is,  as  Hahnemann  asserts,  "  the  sole  law 
of  nature  in  therapeutics,"  a  law  of  which  nothing 
more  than  a  transient  glimpse  ever  presented  itself  to 
the  innumerable  host  of  medical  observers,  is  a  dogma 
of  such  sweeping  extent,  and  pregnant  novelty,  that  it 
demands  a  corresponding  breadth  and  depth  of  un 
questionable  facts  to  cover  its  vast  pretensions. 

So  much  ridicule  has  been  thrown  upon  the  pre 
tended  powers  of  the  minute  doses  that  I  shall  only 
touch  upon  this  point  for  the  purpose  of  conveying, 
by  illustrations,  some  shadow  of  ideas  far  transcending 
the  powers  of  the  imagination  to  realize.  It  must  be 
remembered  that  these  comparisons  are  not  matters 
susceptible  of  dispute,  being  founded  on  simple  arith 
metical  computations,  level  to  the  capacity  of  any  in 
telligent  schoolboy.  A  person  who  once  wrote  a  very 
small  pamphlet  made  some  show  of  objecting  to  cal 
culations  of  this  kind,  on  the  ground  that  the  highest 
dilutions  could  easily  be  made  with  a  few  ounces  of  al 
cohol.  But  he  should  have  remembered  that  at  every 
successive  dilution  he  lays  aside  or  throws  away  ninety- 


HOMtEOPATHY   AND   ITS   KINDRED   DELUSIONS.      53 

nine  hundredths  of  the  fluid  on  which  he  is  operat 
ing,  and  that,  although  he  begins  with  a  drop,  he  only 
prepares  a  millionth,  billionth,  trillionth,  and  similar 
fractions  of  it,  all  of  which,  added  together,  would 
constitute  but  a  vastly  minute  portion  of  the  drop 
with  which  he  began.  But  now  let  us  suppose  we  take 
one  single  drop  of  the  Tincture  of  Camomile,  and  that 
the  whole  of  this  were  to  be  carried  through  the  com 
mon  series  of  dilutions. 

A  calculation  nearly  like  the  following  was  made 
by  Dr.  Panvini,  and  may  be  readily  followed  in  its 
essential  particulars  by  any  one  who  chooses. 

For  the  first  dilution  it  would  take  100  drops  of  al 
cohol. 

For  the  second  dilution  it  would  take  10,000  drops, 
or  about  a  pint. 

For  the  third  dilution  it  would  take  100  pints. 

For  the  fourth  dilution  it  would  take  10,000  pints, 
or  more  than  1,000  gallons,  and  so  on  to  the  ninth 
dilution,  which  would  take  ten  billion  gallons,  which 
he  computed  would  fill  the  basin  of  Lake  Agnano,  a 
body  of  water  two  miles  in  circumference.  The  twelfth 
dilution  would  of  course  fill  a  million  such  lakes.  By 
the  time  the  seventeenth  degree  of  dilution  should  be 
reached,  the  alcohol  required  would  equal  in  quantity 
the  waters  of  ten  thousand  Adriatic  seas.  Trifling  er 
rors  must  be  expected,  but  they  are  as  likely  to  be  on 
one  side  as  the  other,  and  any  little  matter  like  Lake 
Superior  or  the  Caspian  would  be  but  a  drop  in  the 
bucket. 

Swallowers  of  globules,  one  of  your  little  pellets, 
moistened  in  the  mingled  waves  of  one  million  lakes 
of  alcohol,  each  two  miles  in  circumference,  with 
which  had  been  blended  that  one  drop  of  Tincture 


54  MEDICAL   ESSAYS, 

of  Camomile,  would  be  of  precisely  the  strength  rec* 
ommended  for  that  medicine  in  your  favorite  Jahr's 
Manual,  against  the  most  sudden,  frightful,  and  fatal 
diseases ! a 

And  proceeding  on  the  common  data,  I  have  just 
made  a  calculation  which  shows  that  this  single  drop 
of  Tincture  of  Camomile,  given  in  the  quantity  or 
dered  by  Jahr's  Manual,  would  have  supplied  every 
individual  of  the  whole  human  family,  past  and  pres 
ent,  with  more  than  five  billion  doses  each,  the  action 
of  each  dose  lasting  about  four  days. 

Yet  this  is  given  only  at  the  quadrillionth,  or 
fourth  degree  of  potency,  and  various  substances  are 
frequently  administered  at  the  decillionth  or  tenth 
degree,  and  occasionally  at  still  higher  attenuations 
with  professed  medicinal  results.  Is  there  not  in 
this  as  great  an  exception  to  all  the  hitherto  received 
laws  of  nature  as  in  the  miracle  of  the  loaves  and 
fishes?  Ask  this  question  of  a  Homoeopathist,  and 
he  will  answer  by  referring  to  the  effects  produced 
by  a  very  minute  portion  of  vaccine  matter,  or  the 
extraordinary  diffusion  of  odors.  But  the  vaccine 
matter  is  one  of  those  substances  called  morbid  jioi- 
sows,  of  which  it  is  a  peculiar  character  to  multiply 

0  In  the  French  edition  of  1834,  the  proper  doses  of  the  medi 
cines  are  mentioned,  and  Camomile  is  marked  IV.  Why  are 
the  doses  omitted  in  Hull's  Translation,  except  in  three  in 
stances  out  of  the  whole  two  hundred  remedies,  notwithstanding 
the  promise  in  the  preface  that  "  some  remarks  upon  the  doses 
used  may  be  found  at  the  head  of  each  medicine  "  ?  Possibly 
because  it  makes  no  difference  whether  they  are  employed  in 
one  Homoeopathic  dose  or  another  ;  but  then  it  is  very  singular 
that  such  precise  directions  were  formerly  given  in  the  same 
work,  and  that  Hahnemann's  "experience"  should  have  led 
him  to  draw  the  nice  distinctions  we  have  seen  in  a  former  part 
of  this  Lecture  (p.  44). 


HOMOEOPATHY   AND   ITS   KINDRED   DELUSIONS.      55 

themselves,  when  introduced  into  the  system,  as  a 
seed  does  in  the  soil.  Therefore  the  hundredth  part 
of  a  grain  of  the  vaccine  matter,  if  no  more  than  this 
is  employed,  soon  increases  in  quantity,  until,  in  the 
course  of  about  a  week,  it  is  a  grain  or  more,  and 
can  be  removed  in  considerable  drops.  And  what 
is  a  very  curious  illustration  of  Homoaopathy,  it  does 
not  produce  its  most  characteristic  effects  until  it  is 
already  in  sufficient  quantity  not  merely  to  be  visible, 
but  to  be  collected  for  further  use.  The  thought 
lessness  which  can  allow  an  inference  to  be  extended 
from  a  product  of  disease  possessing  this  susceptibil 
ity  of  multiplication  when  conveyed  into  the  living 
body,  to  substances  of  inorganic  origin,  such  as  silex 
or  sulphur,  would  be  capable  of  arguing  that  a  pebble 
may  produce  a  mountain,  because  an  acorn  can  become 
a  forest. 

As  to  the  analogy  to  be  found  between  the  alleged 
action  of  the  infinitely  attenuated  doses,  and  the  ef 
fects  of  some  odorous  substances  which  possess  the 
extraordinary  power  of  diffusing  their  imponderable 
emanations  through  a  very  wide  space,  however  it  may 
be  abused  in  argument,  and  rapidly  as  it  evaporates 
on  examination,  it  is  not  like  that  just  mentioned, 
wholly  without  meaning.  The  fact  of  the  vast  diffu 
sion  of  some  odors,  as  that  of  musk  or  the  rose,  for 
instance,  has  long  been  cited  as  the  most  remarkable 
illustration  of  the  divisibility  of  matter,  and  the 
nicety  of  the  senses.  And  if  this  were  compared 
with  the  effects  of  a  very  minute  dose  of  morphia  on 
the  whole  system,  or  the  sudden  and  fatal  impression 
of  a  single  drop  of  prussic  acid,  or,  with  what  come? 
still  nearer,  the  poisonous  influence  of  an  atmosphere 
impregnated  with  invisible  malaria,  we  should  find  in 


56  MEDICAL  ESSAYS. 

each  of  these  examples  an  evidence  of  the  degree  to 
which  nature,  in  some  few  instances,  concentrate? 
powerful  qualities  in  minute  or  subtile  forms  of  mat 
ter.  But  if  a  man  comes  to  me  with  a  pestle  and 
mortar  in  his  hand,  and  tells  me  that  he  will  take  a 
little  speck  of  some  substance  which  nobody  ever 
thought  to  have  any  smell  at  all,  as,  for  instance,  a 
grain  of  chalk  or  of  charcoal,  and  that  he  will,  after 
an  hour  or  two  of  rubbing  and  scraping,  develop  in  a 
portion  of  it  an  odor  which,  if  the  whole  grain  were 
used,  would  be  capable  of  pervading  an  apartment,  a 
house,  a  village,  a  province,  an  empire,  nay,  the  entire 
atmosphere  of  this  broad  planet  upon  which  we  tread  \ 
and  that  from  each  of  fifty  or  sixty  substances  he 
can  in  this  way  develop  a  distinct  and  hitherto  un 
known  odor ;  and  if  he  tries  to  show  that  all  this  is 
rendered  quite  reasonable  by  the  analogy  of  musk 
and  roses,  I  shall  certainly  be  justified  in  considering 
him  incapable  of  reasoning,  and  beyond  the  reach  of 
my  argument.  What  if,  instead  of  this,  he  professes 
to  develop  new  and  wonderful  medicinal  powers  from 
the  same  speck  of  chalk  or  charcoal,  in  such  propor 
tions  as  would  impregnate  every  pond,  lake,  river,  sea, 
and  ocean  of  our  globe,  and  appeals  to  the  same  anal 
ogy  in  favor  of  the  probability  of  his  assertion. 

All  this  may  be  true,  notwithstanding  these  consid 
erations.  But  so  extraordinary  would  be  the  fact,  that 
a  single  atom  of  substances  which  a  child  might  swal 
low  without  harm  by  the  teaspoonful  could,  by  an 
easy  mechanical  process,  be  made  to  develop  such  in 
conceivable  powers,  that  nothing  but  the  strictest 
agreement  of  the  most  cautious  experimenters,  secured 
by  every  guaranty  that  they  were  honest  and  faithful 
appealing  to  repeated  experiments  in  public,  with 


HOMOEOPATHY   AND   ITS   KINDRED   DELUSIONS.      57 

every  precaution  to  guard  against  error,  and  with  the 
most  plain  and  peremptory  results,  should  induce  us 
to  lend  any  credence  to  such  pretensions. 

The  third  doctrine,  that  Psora,  the  other  name  of 
which  you  remember,  is  the  cause  of  the  great  major 
ity  of  chronic  diseases,  is  a  startling  one,  to  say  the 
least.  That  an  affection  always  recognized  as  a  very 
unpleasant  personal  companion,  but  generally  regarded 
as  a  mere  temporary  incommodity,  readily  yielding  to 
treatment  in  those  unfortunate  enough  to  suffer  from 
it,  and  hardly  known  among  the  better  classes  of  soci 
ety,  should  be  all  at  once  found  out  by  a  German  phy 
sician  to  be  the  great  scourge  of  mankind,  the  cause  of 
their  severest  bodily  and  mental  calamities,  cancer  and 
consumption,  idiocy  and  madness,  must  excite  our  un 
qualified  surprise.  And  when  the  originator  of  this 
singular  truth  ascribes,  as  in  the  page  now  open  before 
me,  the  declining  health  of  a  disgraced  courtier,  the 
chronic  malady  of  a  bereaved  mother,  even  the  melan 
choly  of  the  love-sick  and  slighted  maiden,  to  nothing 
more  nor  less  than  the  insignificant,  unseemly,  and  al 
most  unmentionable  ITCH,  does  it  not  seem  as  if  the 
very  soil  upon  which  we  stand  were  dissolving  into 
chaos,  over  the  earthquake-heaving  of  discovery  ? 

And  when  one  man  claims  to  have  established  these 
three  independent  truths,  which  are  about  as  remote 
from  each  other  as  the  discovery  of  the  law  of  gravita 
tion,  the  invention  of  printing,  and  that  of  the  mari 
ner's  compass,  unless  the  facts  in  their  favor  are  over, 
whelming  and  unanimous,  the  question  naturally  arises, 
Is  not  this  man  deceiving  himself,  or  trying  to  deceive 
others  ? 

I  proceed  to  examine  the  proofs  of  the  leading  ideas 
of  Hahnemann  and  his  school. 


t>8  MEDICAL   ESSAYS. 

In  order  to  show  the  axiom,  similia  similibus  cu* 
rantur  (or  like  is  cured  by  like),  to  be  the  basis  of  the 
healing  art,  —  "  the  sole  law  of  nature  in  therapeu 
tics,"  —  it  is  necessary,  — 

1.  That  the  symptoms  produced  by  drugs  in  healthy 
persons  should  be  faithfully  studied  and  recorded. 

2.  That  drugs  should  be  shown  to  be  always  capa 
ble  of  curing  those  diseases  most  like  their  own  symp 
toms. 

3.  That  remedies  phould  be  shown  not  to  cure  dis 
eases  when  they  do  not  produce  symptoms  resembling 
those  presented  in  these  diseases. 

1.  The  effects  of  drugs  upon  healthy  persons  have 
been  studied  by  Hahnemann  and  his  associates.  Their 
results  were  made  known  in  his  Materia  Medica,  a 
work  in  three  large  volumes  in  the  French  translation, 
published  about  eight  years  ago.  The  mode  of  exper 
imentation  appears  to  have  been,  to  take  the  substance 
on  trial,  either  in  common  or  minute  doses,  and  then 
to  set  down  every  little  sensation,  every  little  move 
ment  of  mind  or  body,  which  occurred  within  many 
succeeding  hours  or  days,  as  being  produced  solely  by 
the  substance  employed.  When  I  have  enumerated 
some  of  the  symptoms  attributed  to  the  power  of  the 
drugs  taken,  you  will  be  able  to  judge  how  much  value 
is  to  be  ascribed  to  the  assertions  of  such  observers. 

The  following  list  was  taken  literally  from  the  Ma 
teria  Medica  of  Hahnemann,  by  my  friend  M.  Ver- 
nois,  for  whose  accuracy  I  am  willing  to  be  responsi 
ble.  He  has  given  seven  pages  of  these  symptoms,  not 
selected,  but  taken  at  hazard  from  the  French  transla 
tion  of  the  work.  I  shall  be  very  brief  in  my  citations. 

"  After  stooping  some  time,  sense  of  painful  weight 
about  the  head  upon  resuming  the  erect  posture." 


HOMOEOPATHY   AND   ITS   KINDRED   DELUSIONS.      53 

"  An  itching,  tickling  sensation  at  the  outer  edge  of 
the  palm  of  the  left  hand,  which  obliges  the  person  to 
scratch."  The  medicine  was  acetate  of  limp.,  and  as 
the  action  of  the  globule  taken  is  said  to  last  twenty- 
eight  days,  you  may  judge  how  many  such  symptoms 
as  the  last  might  be  supposed  to  happen. 

Among  the  symptoms  attributed  to  muriatic  acid 
are  these :  a  catarrh,  sighing,  pimples ;  "  after  having 
written  a  long  time  with  the  back  a  little  bent  over, 
violent  pain  in  the  back  and  shoulder-blades,  as  if 
from  a  strain,"  —  "  dreams  which  are  not  remembered, 
—  disposition  to  mental  dejection,  —  wakefulness  be 
fore  and  after  midnight." 

I  might  extend  this  catalogue  almost  indefinitely.  I 
have  not  cited  these  specimens  with  any  view  to  excit 
ing  a  sense  of  the  ridiculous,  which  many  others  of 
those  mentioned  would  not  fail  to  do,  but  to  show  that 
the  common  accidents  of  sensation,  the  little  bodily  in 
conveniences  to  which  all  of  us  are  subject,  are  seri 
ously  and  systematically  ascribed  to  whatever  medicine 
may  have  been  exhibited,  even  in  the  minute  doses  I 
have  mentioned,  whole  days  or  weeks  previously. 

To  these  are  added  all  the  symptoms  ever  said  by 
anybody,  whether  deserving  confidence  or  not,  as  I 
shall  hereafter  illustrate,  to  be  produced  by  the  sub 
stance  in  question. 

The  effects  of  sixty-four  medicinal  substances,  as 
certained  by  one  or  both  of  these  methods,  are  enumer 
ated  in  the  Materia  Medica  of  Hahnemann,  which 
may  be  considered  as  the  basis  of  practical  Homoe 
opathy.  In  the  Manual  of  Jahr,  which  is  the  common 
guide,  so  far  as  I  know,  of  those  who  practise  Homoe 
opathy  in  these  regions,  two  hundred  remedies  are 
enumerated,  many  of  which,  however,  have  never  been 


60  MEDICAL  ESSAYS. 

employed  in  practice.  In  at  least  one  edition  there 
were  no  means  of  distinguishing  those  which  had  been 
tried  upon  the  sick  from  the  others.  It  is  true  that 
marks  have  been  added  in  the  edition  employed  here, 
which  serve  to  distinguish  them ;  but  what  are  we  to 
think  of  a  standard  practical  author  on  Materia  Med- 
ica,  who  at  one  time  omits  to  designate  the  proper 
doses  of  his  remedies,  and  at  another  to  let  us  have 
any  means  of  knowing  whether  a  remedy  has  ever 
been  tried  or  not,  while  he  is  recommending  its  em 
ployment  in  the  most  critical  and  threatening  diseases  ? 

I  think  that,  from  what  I  have  shown  of  the  char 
acter  of  Hahnemann's  experiments,  it  would  be  a  sat- 
isfaction  to  any  candid  inquirer  to  know  whether 
other  persons,  to  whose  assertions  he  could  look  with 
confidence,  confirm  these  pretended  facts.  Now  there 
are  many  individuals,  long  and  well  known  to  the  sci 
entific  world,  who  have  tried  these  experiments  upon 
healthy  subjects,  and  utterly  deny  that  their  effects 
have  at  all  corresponded  to  Hahnemann's  assertions. 

I  will  take,  for  instance,  the  statements  of  Andral 
(and  I  am  not  referring  to  his  well-known  public  ex 
periments  in  his  hospital)  as  to  the  result  of  his  own 
trials.  This  distinguished  physician  is  Professor  of 
Medicine  in  the  School  of  Paris,  and  one  of  the  most 
widely  known  and  valued  authors  upon  practical  and 
theoretical  subjects  the  profession  can  claim  in  any 
country.  He  is  a  man  of  great  kindness  of  character, 
a  most  liberal  eclectic  by  nature  and  habit,  of  unques 
tioned  integrity,  and  is  called,  in  the  leading  article  of 
the  first  number  of  the  "  Homoepathic  Examiner,"  "  an 
eminent  and  very  enlightened  allopathist."  Assisted 
by  a  number  of  other  persons  in  good  health,  he  ex 
perimented  on  the  effects  of  cinchona,  aconite,  sulphur, 


HOMCEOPATHY  AND  ITS  KINDRED  DELUSIONS.      61 

arnica,  and  the  other  most  highly  extolled  remedies. 
His  experiments  lasted  a  year,  and  he  stated  publicly 
to  the  Academy  of  Medicine  that  they  never  pro 
duced  the  slightest  appearance  of  the  symptoms  at 
tributed  to  them.  The  results  of  a  man  like  this,  so 
extensively  known  as  one  of  the  most  philosophical 
and  candid,  as  well  as  brilliant  of  instructors,  and 
whose  admirable  abilities  and  signal  liberality  are  gen 
erally  conceded,  ought  to  be  of  great  weight  in  decid 
ing  the  question. 

M.  Double,  a  well-known  medical  writer  and  a  phy 
sician  of  high  standing  in  Paris,  had  occasion  so  long 
ago  as  1801,  before  he  had  heard  of  Homoeopathy,  to 
make  experiments  upon  Cinchona,  or  Peruvian  bark. 
He  and  several  others  took  the  drug  in  every  kind  of 
dose  for  four  months,  and  the  fever  it  is  pretended  by 
Hahnemann  to  excite  never  was  produced. 

M.  Bonnet,  President  of  the  Royal  Society  of  Medi 
cine  of  Bordeaux,  had  occasion  to  observe  many  sol 
diers  during  the  Peninsular  War,  who  made  use  of 
Cinchona  as  a  preservative  against  different  diseases, 
— but  he  never  found  it  to  produce  the  pretended  par 
oxysms. 

If  any  objection  were  made  to  evidence  of  this  kind, 
I  would  refer  to  the  express  experiments  on  many  of 
the  Homoeopathic  substances,  which  were  given  to 
healthy  persons  with  every  precaution  as  to  diet  and 
regimen,  by  M.  Louis  Fleury,  without  being  followed 
by  the  slightest  of  the  pretended  consequences.  And 
let  me  mention  as  a  curious  fact,  that  the  same  quan 
tity  of  arsenic  given  to  one  animal  in  the  common  form 
of  the  unprepared  powder,  and  to  another  after  hav 
ing  been  rubbed  up  into  six  hundred  globules,  offered 
no  particular  difference  of  activity  in  the  two  cases. 


62  MEDICAL  ESSAYS. 

This  is  a  strange  contradiction  to  the  doctrine  of  the 
development  of  what  they  call  dynamic  power,  by 
means  of  friction  and  subdivision. 

In  1835  a  public  challenge  was  offered  to  the  best- 
known  Homoeopathic  physician  in  Paris  to  select  any 
ten  substances  asserted  to  produce  the  most  striking 
effects ;  to  prepare  them  himself ;  to  choose  one  by  lot 
without  knowing  which  of  them  he  had  taken,  and  try 
it  upon  himself  or  any  intelligent  and  devoted  Homo3- 
opathist,  and,  waiting  his  own  time,  to  come  forward 
and  tell  what  substance  had  been  employed.  The 
challenge  was  at  first  accepted,  but  the  acceptance  re 
tracted  before  the  time  of  trial  arrived. 

From  all  this  I  think  it  fair  to  conclude  that  the  cat 
alogues  of  symptoms  attributed  in  Homoeopathic  works 
to  the  influence  of  various  drugs  upon  healthy  persons 
are  not  entitled  to  any  confidence. 

2.  It  is  necessary  to  show,  in  the  next  place,  that 
medicinal  substances  are  always  capable  of  curing  dis 
eases  most  like  their  own  symptoms.  For  facts  relat 
ing  to  this  question  we  must  look  to  two  sources ;  the 
recorded  experience  of  the  medical  profession  in  gen 
eral,  and  the  results  of  trials  made  according  to  Homoe 
opathic  principles,  and  capable  of  testing  the  truth  of 
the  doctrine. 

No  person,  that  I  am  aware  of,  has  ever  denied  that 
in  some  cases  there  exists  a  resemblance  between  the 
effects  of  a  remedy  and  the  symptoms  of  diseases  in 
which  it  is  beneficial.  This  has  been  recognized,  as 
Hahnemann  himself  has  shown,  from  the  time  of  Hip 
pocrates.  But  according  to  the  records  of  the  medi 
cal  profession,  as  they  have  been  hitherto  interpreted, 
this  is  true  of  only  a  very  small  proportion  of  useful 
remedies.  Nor  has  it  ever  been  considered  as  an  es 


HOMOEOPATHY   AND   IIS   KINDRED   DELUSIONS,      63 

fcablished  truth  that  the  efficacy  of  even  these  few  rem 
edies  was  in  any  definite  ratio  to  their  power  of  pro 
ducing  symptoms  more  or  less  like  those  they  cured. 

Such  was  the  state  of  opinion  when  Hahnemann 
came  forward  with  the  proposition  that  all  the  cases  of 
successful  treatment  found  in  the  works  of  all  preced 
ing  medical  writers  were  to  be  ascribed  solely  to  the 
operation  of  the  Homo3opathic  principle,  which  had 
effected  the  cure,  although  without  the  physician's 
knowledge  that  this  was  the  real  secret.  And  strange 
as  it  may  seem,  he  was  enabled  to  give  such  a  degree 
of  plausibility  to  this  assertion,  that  any  person  not  ac 
quainted  somewhat  with  medical  literature,  not  quite 
familiar,  I  should  rather  say,  with  the  relative  value  of 
medical  evidence,  according  to  the  sources  whence  it  is 
derived,  would  be  almost  frightened  into  the  belief,  at 
seeing  the  pages  upon  pages  of  Latin  names  he  has 
summoned  as  his  witnesses. 

It  has  hitherto  been  customary,  when  examining  the 
writings  of  authors  of  preceding  ages,  upon  subjects  as 
to  which  they  were  less  enlightened  than  ourselves,  and 
which  they  were  very  liable  to  misrepresent,  to  exer 
cise  some  little  discretion;  to  discriminate,  in  some 
measure,  between  writers  deserving  confidence  and 
those  not  entitled  to  it.  But  there  is  not  the  least  ap 
pearance  of  any  such  delicacy  on  the  part  of  Hahne 
mann.  A  large  majority  of  the  names  of  old  authors 
he  cites  are  wholly  unknown  to  science.  With  some 
of  them  I  have  been  long  acquainted,  and  I  know  that 
their  accounts  of  diseases  are  no  more  to  be  trusted 
than  their  contemporary  Ambroise  Park's  stories  of 
mermen,  and  similar  absurdities.  But  if  my  judgment 
is  rejected,  as  being  a  prejudiced  one,  1  can  refer  to 
Cullen,  who  mentioned  three  of  Hahnemann's  authors 


64  MEDICAL   ESSAYS. 

in  one  sentence,  as  being  "  not  necessarily  bad  authori 
ties  ;  but  certainly  such  when  they  delivered  very  im 
probable  events ;  "  and  as  this  was  said  more  than  half 
a  century  ago,  it  could  not  have  had  any  reference  to 
Hahnemann.  But  although  not  the  slightest  sign  of 
discrimination  is  visible  in  his  quotations,  —  although 
for  him  a  handful  of  chaff  from  Schenck  is  all  the 
same  thing  as  a  measure  of  wheat  from  Morgagni,  — 
there  is  a  formidable  display  of  authorities,  and  an 
abundant  proof  of  ingenious  researches  to  be  found  in 
each  of  the  great  works  of  Hahnemann  with  which  I 
am  familiar." 

It  is  stated  by  Dr.  Leo- Wolf ,  that  Professor  Joerg, 
of  Leipsic,  has  proved  many  of  Hahnemann's  quota 
tions  from  old  authors  to  be  adulterate  and  false. 
What  particular  instances  he  has  pointed  out  I  have 
no  means  of  learning.  And  it  is  probably  wholly  im 
possible  on  this  side  of  the  Atlantic,  and  even  in  most 
of  the  public  libraries  of  Europe,  to  find  anything 
more  than  a  small  fraction  of  the  innumerable  obscure 
publications  which  the  neglect  of  grocers  and  trunk- 
makers  has  spared  to  be  ransacked  by  the  all-devouring 
genius  of  Homoeopathy.  I  have  endeavored  to  verify 
such  passages  as  my  own  library  afforded  me  the 
means  of  doing.  For  some  I  have  looked  in  vain,  for 
want,  as  I  am  willing  to  believe,  of  more  exact  refer 
ences.  But  this  I  am  able  to  affirm,  that,  out  of  the  very 
small  number  which  I  have  been  able  to  trace  back  to 

a  Some  painful  surmises  might  arise  as  to  the  erudition  of 
Hahnemann's  English  Translator,  who  makes  two  individuals  of 
"  Zacutus,  Lucitanus,"  as  well  as  respecting  that  of  the  conduc 
tors  of  an  American  Homoeopathic  periodical,  who  suffer  the 
name  of  the  world-renowned  Cardanus  to  be  spelt  Cardamus  in 
at  least  three  places,  were  not  this  gross  ignorance  of  course  at 
tributable  only  to  the  printer. 


HOMCEOPATHY   AND   ITS   KINDRED   DELUSIONS.     65 

their  original  authors,  I  have  found  two  to  be  wrongly 
quoted,  one  of  them  being  a  gross  misrepresentation. 

The  first  is  from  the  ancient  Roman  author,  Caelius 
Aurelianus;  the  second  from  the  venerable  folio  of 
Forestus.  Hahnemann  uses  the  following  expressions, 
—  if  he  is  not  misrepresented  in  the  English  Transla 
tion  of  the  "  Organon  "  :  "  Asclepiades  on  one  occasion 
cured  an  inflammation  of  the  brain  by  administering 
a  small  quantity  of  wine."  After  correcting  the  erro 
neous  reference  of  the  Translator,  I  can  find  no  such 
case  alluded  to  in  the  chapter.  But  Caelius  Aurelianus 
mentions  two  modes  of  treatment  employed  by  Ascle 
piades,  into  both  of  which  the  use  of  wine  entered,  as 
being  in  the  highest  degree  irrational  and  dangerous.* 

In  speaking  of  the  oil  of  anise-seed,  Hahnemann 
says  that  Forestus  observed  violent  colic  caused  by  its 
administration.  But,  as  the  author  tells  the  story,  a 
young  man  took,  by  the  counsel  of  a  surgeon,  an  acrid 
and  virulent  medicine,  the  name  of  which  is  not  given, 
which  brought  on  a  most  cruel  fit  of  the  gripes  and 
colic.  After  this  another  surgeon  was  called,  who 
gave  him  oil  of  anise-seed  and  wine,  which  increased 
his  suffering.6  Now  if  this  was  the  Homoaopathic 
remedy,  as  Hahnemann  pretends,  it  might  be  a  fair 
question  why  the  young  man  was  not  cured  by  it. 
But  it  is  a  much  graver  question  why  a  man  who  has 
shrewdness  and  learning  enough  to  go  so  far  after  his 
facts,  should  think  it  right  to  treat  them  with  such 
astonishing  negligence  or  such  artful  unfairness. 

Even  if  every  word  he  had  pretended  to  take  from 
Ids  old  authorities  were  to  be  found  in  them,  even  if 

•  Ccelius  Aurel.  De  Morb.  Acut.  et  Chron.  lib.  L  cap.  xv.  not 
xvi.    Amsterdam.     Wetstein,  1755. 

*  Observ.  et  Curat.  Med.  lib.  XXL  obs.  xiii.     Frankfort,  1614 


66  MEDICAL   ESSAYS. 

the  authority  of  every  one  of  these  authors  were  be 
yond  question,  the  looseness  with  which  they  are  used 
to  prove  whatever  Hahnemann  chooses  is  beyond  the 
bounds  of  credibility.  Let  me  give  one  instance  to 
illustrate  the  character  of  this  man's  mind.  Hahne 
mann  asserts,  in  a  note  annexed  to  the  110th  para 
graph  of  the  "  Organon,"  that  the  smell  of  the  rose  will 
cause  certain  persons  to  faint.  And  he  says  in  the 
text  that  substances  which  produce  peculiar  effects  of 
this  nature  on  particular  constitutions  cure  the  same 
symptoms  in  people  in  general.  Then  in  another  note 
to  the  same  paragraph  he  quotes  the  following  fact 
from  one  of  the  last  sources  one  would  have  looked  to 
for  medical  information,  the  Byzantine  Historians. 

"  It  was  by  these  means  "  (i.  e.  Homosopathically) 
"  that  the  Princess  Eudosia  with  rose-water  restored 
a  person  who  had  fainted  !  " 

Is  it  possible  that  a  man  who  is  guilty  of  such  pe 
dantic  folly  as  this,  —  a  man  who  can  see  a  confirma 
tion  of  his  doctrine  in  such  a  recovery  as  this,  —  a  re 
covery  which  is  happening  every  day,  from  a  breath 
of  air,  a  drop  or  two  of  water,  untying  a  bonnet- 
string,  loosening  a  stay-lace,  and  which  can  hardly 
help  happening,  whatever  is  done,  —  is  it  possible 
that  a  man,  of  whose  pages,  not  here  and  there  one, 
but  hundreds  upon  hundreds  are  loaded  with  such 
trivialities,  is  the  Newton,  the  Columbus,  the  Harvey 
of  the  nineteenth  century  ! 

The  whole  process  of  demonstration  he  employs  is 
this.  An  experiment  is  instituted  with  some  drug 
upon  one  or  more  healthy  persons.  Everything  that 
happens  for  a  number  of  days  or  weeks  is,  as  we  have 
seen,  set  down  as  an  effect  of  the  medicine.  Old  vol 
umes  are  then  ransacked  promiscuously,  and  every 


HOMOEOPATHY   AND   ITS   KINDRED   DELUSIONS.     6T 

morbid  sensation  or  change  that  anybody  ever  said 
was  produced  by  the  drug  in  question  is  added  to  the 
list  of  symptoms.  By  one  or  both  of  these  methods, 
each  of  the  sixty-four  substances  enumerated  by  Hah- 
nemann  is  shown  to  produce  a  very  large  number  of 
symptoms,  the  lowest  in  his  scale  being  ninety-seven, 
and  the  highest  fourteen  hundred  and  ninety-one. 
And  having  made  out  this  list  respecting  any  drug,  a 
catalogue  which,  as  you  may  observe  in  any  Homoeo 
pathic  manual,  contains  various  symptoms  belonging 
to  every  organ  of  the  body,  what  can  be  easier  than  to 
find  alleged  cures  in  every  medical  author  which  can 
at  once  be  attributed  to  the  Homoeopathic  principle ; 
still  more  if  the  grave  of  extinguished  credulity  is 
called  upon  to  give  up  its  dead  bones  as  living  wit 
nesses  ;  and  worst  of  all,  if  the  monuments  of  the  past 
are  to  be  mutilated  in  favor  of  "  the  sole  law  of  Nature 
in  therapeutics  "  ? 

There  are  a  few  familiar  facts  of  which  great  use 
has  been  made  as  an  entering  wedge  for  the  Homoeo 
pathic  doctrine.  They  have  been  suffered  to  pass  cur 
rent  so  long  that  it  is  time  they  should  be  nailed  to 
the  counter,  a  little  operation  which  I  undertake,  with 
perfect  cheerfulness,  to  perform  for  them. 

The  first  is  a  supposed  illustration  of  the  Homoeo 
pathic  law  found  in  the  precept  given  for  the  treat 
ment  of  parts  which  have  been  frozen,  by  friction  with 
snow  or  similar  means.  But  we  deceive  ourselves  by 
names,  if  we  suppose  the  frozen  part  to  be  treated  by 
cold,  and  not  by  heat.  The  snow  may  even  be  act 
ually  warmer  than  the  part  to  which  it  is  applied. 
But  even  if  it  were  at  the  same  temperature  when  ap 
plied,  it  never  did  and  never  could  do  the  least  good 
to  a  frozen  part,  except  as  a  mode  of  regulating  the 


68  MEDICAL  ESSAYS. 

application  of  what  ?  of  heat.  But  the  heat  must  be 
applied  gradually,  just  as  food  must  be  given  a  little 
at  a  time  to  those  perishing  with  hunger.  If  the  pa 
tient  were  brought  into  a  warm  room,  heat  would  be 
applied  very  rapidly,  were  not  something  interposed 
to  prevent  this,  and  allow  its  gradual  admission. 
Snow  or  iced  water  is  exactly  what  is  wanted ;  it  is 
not  cold  to  the  part ;  it  is  very  possibly  warm,  on  the 
contrary,  for  these  terms  are  relative,  and  if  it  does 
not  melt  and  let  the  heat  in,  or  is  not  taken  away,  the 
part  will  remain  frozen  up  until  doomsday.  Now  the 
treatment  of  a  frozen  limb  by  heat,  in  large  or  small 
quantities,  is  not  Homoeopathy. 

The  next  supposed  illustration  of  the  HomxBOpathic 
law  is  the  alleged  successful  management  of  burns,  by 
holding  them  to  the  fire.  This  is  a  popular  mode  of 
treating  those  burns  which  are  of  too  little  consequence 
to  require  any  more  efficacious  remedy,  and  would 
inevitably  get  well  of  themselves,  without  any  trouble 
being  bestowed  upon  them.  It  produces  a  most  acute 
pain  in  the  part,  which  is  followed  by  some  loss  of 
sensibility,  as  happens  with  the  eye  after  exposure 
to  strong  light,  and  the  ear  after  being  subjected 
to  very  intense  sounds.  This  is  all  it  is  capable  of 
doing,  and  all  further  notions  of  its  efficacy  must  be 
attributed  merely  to  the  vulgar  love  of  paradox.  If 
this  example  affords  any  comfort  to  the  Homo3opathist, 
it  seems  as  cruel  to  deprive  him  of  it  as  it  would  be  to 
convince  the  mistress  of  the  smoke-jack  or  the  flat- 
iron  that  the  fire  does  not  literally  "draw  the  fire 
out,"  which  is  her  hypothesis. 

But  if  it  were  true  that  frost-bites  were  cured  by 
cold  and  burns  by  heat,  it  would  be  subversive,  so 
far  as  it  went,  of  the  great  principle  of  Homoeopathy. 


HOMOEOPATHY   AND   ITS   KINDRED   DELUSIONS.      69 

For  you  will  remember  that  this  principle  is  that 
Like  cures  Like,  and  not  that  Same  cures  Same; 
that  there  is  resemblance  and  not  identity  between 
the  symptoms  of  the  disease  and  those  produced  by 
the  drug  which  cures  it,  and  none  have  been  readier 
to  insist  upon  this  distinction  than  the  Homceopa- 
thists  themselves.  For  if  Same  cures  Same,  then 
every  poison  must  be  its  own  antidote,  —  which  is 
neither  a  part  of  their  theory  nor  their  so-called  ex 
perience.  They  have  been  asked  often  enough,  why 
it  was  that  arsenic  could  not  cure  the  mischief  which 
arsenic  had  caused,  and  why  the  infectious  cause 
of  small-pox  did  not  remedy  the  disease  it  had  pro 
duced,  and  then  they  were  ready  enough  to  see  the 
distinction  I  have  pointed  out.  O  no  !  it  was  not  the 
hair  of  the  same  dog,  but  only  of  one  very  much  like 

him  ! 

A  third  instance  in  proof  of  the  Homoeopathic  law 
is  sought  for  in  the  acknowledged  efficacy  of  vaccina 
tion.  And  how  does  the  law  apply  to  this?  It  is 
granted  by  the  advocates  of  Homoaopathy  that  there  is 
a  resemblance  between  the  effects  of  the  vaccine  virus 
on  a  person  in  health  and  the  symptoms  of  small-pox. 
Therefore,  according  to  the  rule,  the  vaccine  virus 
will  cure  the  small-pox,  which,  as  everybody  knows,  is 
entirely  untrue.  But  it  prevents  small-pox,  say  the 
Homoeopathists.  Yes,  and  so  does  small-pox  prevent 
itself  from  ever  happening  again,  and  we  know  just 
as  much  of  the  principle  involved  in  the  one  case  as 
in  the  other.  For  this  is  only  one  of  a  series  of  facts 
which  we  are  wholly  unable  to  explain.  Small-pox, 
measles,  scarlet-fever,  hooping-cough,  protect  those 
who  have  them  once  from  future  attacks ;  but  nettle- 
rash  and  catarrh  and  lung  fever,  each  of  which  i? 


70  MEDICAL   ESSAYS. 

just  as  Homoeopathic  to  itself  as  any  one  of  the  others^ 
have  no  such  preservative  power.  We  are  obliged  to 
accept  the  fact,  unexplained,  and  we  can  do  no  more 
for  vaccination  than  for  the  rest. 

I  come  now  to  the  most  directly  practical  point 
connected  with  the  subject,  namely,  — 

What  is  the  state  of  the  evidence  as  to  the  efficacy 
of  the  proper  HomoBopathic  treatment  in  the  cure  of 
diseases. 

As  the  treatment  adopted  by  the  Homoeopathists 
has  been  almost  universally  by  means  of  the  infini 
tesimal  doses,  the  question  of  their  efficacy  is  thrown 
open,  in  common  with  that  of  the  truth  of  their  fun 
damental  axiom,  as  both  are  tested  in  practice. 

We  must  look  for  facts  as  to  the  actual  working  of 
Homo3opathy  to  three  sources. 

1.  The  statements  of  the  unprofessional  public. 

2.  The  assertions  of  Homoeopathic  practitioners. 

3.  The  results  of  trials  by  competent  and  honest 
physicians,  not  pledged  to  the  system. 

I  think,  after  what  we  have  seen  of  medical  facts,  as 
they  are  represented  by  incompetent  persons,  we  are 
disposed  to  attribute  little  value  to  all  statements  of 
wonderful  cures,  coming  from  those  who  have  never 
been  accustomed  to  watch  the  caprices  of  disease,  and 
have  not  cooled  down  their  young  enthusiasm  by  the 
habit  of  tranquil  observation.  Those  who  know  noth 
ing  of  the  natural  progress  of  a  malady,  of  its  ordinary 
duration,  of  its  various  modes  of  terminating,  of  its  lia 
bility  to  accidental  complications,  of  the  signs  which 
mark  its  insignificance  or  severity,  of  what  is  to  be  ex. 
pected  of  it  when  left  to  itself,  of  how  much  or  how  lit 
tle  is  to  be  anticipated  from  remedies,  those  who  know 


HOMOEOPATHY   AND   ITS   KINDRED   DELUSIONS.      71 

nothing  or  next  to  nothing  of  all  these  things,  and  who 
are  in  a  great  state  of  excitement  from  benevolence, 
sympathy,  or  zeal  for  a  new  medical  discovery,  can 
hardly  be  expected  to  be  sound  judges  of  facts  which 
have  misled  so  many  sagacious  men,  who  have  spent 
their  lives  in  the  daily  study  and  observation  of  them, 
I  believe  that,  after  having  drawn  the  portrait  of  de 
funct  Perkinism,  with  its  five  thousand  printed  cures, 
and  its  million  and  a  half  computed  ones,  its  miracles 
blazoned  about  through  America,  Denmark,  and  Eng 
land  ;  after  relating  that  forty  years  ago  women  car 
ried  the  Tractors  about  in  their  pockets,  and  workmen 
could  not  make  them  fast  enough  for  the  public  de 
mand  ;  and  then  showing  you,  as  a  curiosity,  a  single 
one  of  these  instruments,  an  odd  one  of  a  pair,  which 
I  obtained  only  by  a  lucky  accident,  so  utterly  lost  is 
the  memory  of  all  their  wonderful  achievements;  I 
believe,  after  all  this,  I  need  not  waste  time  in  showing 
that  medical  acpuracy  is  not  to  be  looked  for  in  the 
florid  reports  of  benevolent  associations,  the  assertions 
of  illustrious  patrons,  the  lax  effusions  of  daily  jour 
nals,  or  the  effervescent  gossip  of  the  tea-table. 

Dr.  Hering,  whose  name  is  somewhat  familiar  to  the 
champions  of  Homo3opathy,  has  said  that  "  the  new 
healing  art  is  not  to  be  judged  by  its  success  in  isolated 
cases  only,  but  according  to  its  success  in  general,  its 
innate  truth,  and  the  incontrovertible  nature  of  its  in 
nate  principles." 

We  have  seen  something  of  "  the  incontrovertible 
nature  of  its  innate  principles,"  and  it  seems  probable, 
on  the  whole,  that  its  success  in  general  must  be  made 
up  of  its  success  in  isolated  cases.  Some  attempts 
have  been  made,  however,  to  finish  the  whole  matter 
by  sweeping  statistical  documents,  which  are  intended 


72  MEDICAL  ESSAYS. 

to  prove  its  triumphant  success  over  the  common  prac* 
tice. 

It  is  well  known  to  those  who  have  had  the  good 
fortune  to  see  the  "  Homoeopathic  Examiner,"  that  this 
journal  led  off,  in  its  first  number,  with  a  grand  dis 
play  of  everything  the  newly  imported  doctrine  had  to 
show  for  itself.  It  is  well  remarked,  on  the  twenty- 
third  page  of  this  article,  that  "  the  comparison  of  bills 
of  mortality  among  an  equal  number  of  sick,  treated 
by  divers  methods,  is  a  most  poor  and  lame  way  to  get 
at  conclusions  touching  principles  of  the  healing  art." 
In  confirmation  of  which,  the  author  proceeds  upon  the 
twenty-fifth  page  to  prove  the  superiority  of  the  Homce- 
opathic  treatment  of  cholera,  by  precisely  these  very 
bills  of  mortality.  Now,  every  intelligent  physician  is 
aware  that  the  poison  of  cholera  differed  so  much  hi  its 
activity  at  different  times  and  places,  that  it  was  next 
to  impossible  to  form  any  opinion  as  to  the  results  of 
treatment,  unless  every  precaution  was  taken  to  secure 
the  most  perfectly  corresponding  conditions  in  the 
patients  treated,  and  hardly  even  then.  Of  course, 
then,  a  Russian  Admiral,  by  the  name  of  Mordvinow, 
backed  by  a  number  of  so-called  physicians  practising 
in  Russian  villages,  is  singularly  competent  to  the  task 
of  settling  the  whole  question  of  the  utility  of  this  or 
that  kind  of  treatment;  to  prove  that,  if  not  more 
than  eight  and  a  half  per  cent,  of  those  attacked  with 
the  disease  perished,  the  rest  owed  their  immunity  to 
Hahnemann.  I  can  remember  when  more  than  a  hun 
dred  patients  in  a  public  institution  were  attacked 
with  what,  I  doubt  not,  many  Homo3opathic  physicians 
(to  say  nothing  of  Homoeopathic  admirals)  would 
have  called  cholera,  and  not  one  of  them  died,  though 
treated  in  the  common  way,  and  it  is  my  firm  belief 


HOMCEOPATHY  AND   ITS   KINDRED   DELUSIONS.      73 

that,  if  such  a  result  had  followed  the  administration 
of  the  omnipotent  globules,  it  would  have  been  in  the 
mouth  of  every  adept  in  Europe,  from  Quin  of  Lon 
don  to  Spohr  of  Gandersheim.  No  longer  ago  than 
yesterday,  in  one  of  the  most  widely  circulated  papers 
of  this  city.,  there  was  published  an  assertion  that  the 
mortality  in  several  Homoaopathic  Hospitals  was  not 
quite  five  in  a  hundred,  whereas,  in  what  are  called 
by  the  writer  Allopathic  Hospitals,  it  is  said  to  be 
eleven  in  a  hundred.  An  honest  man  should  be 
ashamed  of  such  an  argumentwn  ad  ignorantiam. 
The  mortality  of  a  hospital  depends  not  merely  on  the 
treatment  of  the  patients,  but  on  the  class  of  diseases 
it  is  in  the  habit  of  receiving,  on  the  place  where  it  is, 
on  the  season,  and  many  other  circumstances.  For  in 
stance,  there  are  many  hospitals  in  the  great  cities  of 
Europe  that  receive  few  diseases  of  a  nature  to  endan 
ger  life,  and,  on  the  other  hand,  there  are  others  where 
dangerous  diseases  are  accumulated  out  of  the  com 
mon  proportion.  Thus,  in  the  wards  of  Louis,  at  the 
Hospital  of  La  Pitie",  a  vast  number  of  patients  in  the 
last  stages  of  consumption  were  constantly  entering, 
to  swell  the  mortality  of  that  hospital.  It  was  be 
cause  he  was  known  to  pay  particular  attention  to  the 
diseases  of  the  chest  that  patients  laboring  under 
those  fatal  affections  to  an  incurable  extent  were  so 
constantly  coming  in  upon  him.  It  is  always  a  miser 
able  appeal  to  the  thoughtlessness  of  the  vulgar,  to  al 
lege  the  naked  fact  of  the  less  comparative  mortality 
in  the  practice  of  one  hospital  or  of  one  physician 
than  another,  as  an  evidence  of  the  superiority  of 
their  treatment.  Other  things  being  equal,  it  must 
always  be  expected  that  those  institutions  and  individ 
uals  enjoying  to  the  highest  degree  the  confidence  of 


74  MEDICAL  ESSAYS. 

the  community  will  lose  the  largest  proportion  of  theil 
patients ;  for  the  simple  reason  that  they  will  natu 
rally  be  looked  to  by  those  suffering  from  the  gravest 
class  of  diseases  ;  that  many,  who  know  that  they  are 
affected  with  mortal  disease,  will  choose  to  die  under 
their  care  or  shelter,  while  the  subjects  of  trifling  mal 
adies,  and  merely  troublesome  symptoms,  amuse  them 
selves  to  any  extent  among  the  fancy  practitioners. 
When,  therefore,  Dr.  Muhlenbein,  as  stated  in  the 
"  Homo3opathic  Examiner,"  and  quoted  in  yesterday's 
"  Daily  Advertiser,"  asserts  that  the  mortality  among 
his  patients  is  only  one  per  cent,  since  he  has  practised 
Homoeopathy,  whereas  it  was  six  per  cent,  when  he 
employed  the  common  mode  of  practice,  I  am  con 
vinced  by  this,  his  own  statement,  that  the  citizens  of 
Brunswick,  whenever  they  are  seriously  sick,  take 
good  care  not  to  send  for  Dr.  Muhlenbein  ! 

It  is  evidently  impossible  that  I  should  attempt, 
within  the  compass  of  a  single  lecture,  any  detailed 
examination  of  the  very  numerous  cases  reported  in 
the  Homoeopathic  Treatises  and  Journals.  Having 
been  in  the  habit  of  receiving  the  French  "  Archives  of 
Homoeopathic  Medicine "  until  the  premature  decease 
of  that  Journal,  I  have  had  the  opportunity  of  becom 
ing  acquainted  somewhat  with  the  style  of  these  doc 
uments,  and  experiencing  whatever  degree  of  convic 
tion  they  were  calculated  to  produce.  Although  of 
course  I  do  not  wish  any  value  to  be  assumed  for  my 
opinion,  such  as  it  is,  I  consider  that  you  are  entitled 
to  hear  it.  So  far,  then,  as  I  am  acquainted  with  the 
general  character  of  the  cases  reported  by  the  Homoe 
opathic  physicians,  they  would  for  the  most  part  be 
considered  as  wholly  undeserving  a  place  in  any  Eng 
lish,  French,  or  American  periodical  of  high  standing, 


HOM(EOPATHY   AND   ITS   KINDRED   DELUSIONS.      75 

if,  instead  of  favoring  the  doctrine  they  were  intended 
to  support,  they  were  brought  forward  to  prove  the 
efficacy  of  any  common  remedy  administered  by  any 
common  practitioner.  There  are  occasional  exceptions 
to  this  remark ;  but  the  general  truth  of  it  is  rendered 
probable  by  the  fact  that  these  cases  are  always,  or 
almost  always,  written  with  the  single  object  of  show 
ing  the  efficacy  of  the  medicine  used,  or  the  skill  of 
the  practitioner,  and  it  is  recognized  as  a  general  rule 
that  such  cases  deserve  very  little  confidence.  Yet 
they  may  sound  well  enough,  one  at  a  time,  to  those 
who  are  not  fully  aware  of  the  fallacies  of  medical 
evidence.  Let  me  state  a  case  in  illustration.  Nobody 
doubts  that  some  patients  recover  under  every  form  of 
practice.  Probably  all  are  willing  to  allow  that  a 
large  majority,  for  instance,  ninety  in  a  hundred,  of 
such  cases  as  a  physician  is  called  to  in  daily  practice, 
would  recover,  sooner  or  later,  with  more  or  less  diffi 
culty,  provided  nothing  were  done  to  interfere  seri 
ously  with  the  efforts  of  nature. 

Suppose,  then,  a  physician  who  has  a  hundred  pa 
tients  prescribes  to  each  of  them  pills  made  of  some 
entirely  inert  substance,  as  starch,  for  instance.  Ninety 
of  them  get  well,  or  if  he  chooses  to  use  such  language, 
he  cures  ninety  of  them.  It  is  evident,  according  to 
the  doctrine  of  chances,  that  there  must  be  a  consider 
able  number  of  coincidences  between  the  relief  of  the 
patient  and  the  administration  of  the  remedy.  It  is 
altogether  probable  that  there  will  happen  two  or  three 
very  striking  coincidences  out  of  the  whole  ninety 
cases,  in  which  it  would  seem  evident  that  the  medi* 
cine  produced  the  relief,  though  it  had,  as  we  assumed, 
nothing  to  do  with  it.  Now  suppose  that  the  physi 
cian  publishes  these  cases,  will  they  not  have  a  plausi' 


76  MEDICAL  ESSAYS. 

ble  appearance  of  proving  that  which,  as  we  granted 
at  the  outset,  was  entirely  false?  Suppose  that  in 
stead  of  pills  of  starch  he  employs  microscopic  sugar 
plums,  with  the  five  million  billion  trillionth  part  of  a 
suspicion  of  aconite  or  pulsatilla,  and  then  publishes 
his  successful  cases,  through  the  leaden  lips  of  the 
press,  or  the  living  ones  of  his  female  acquaintances, 
—  does  that  make  the  impression  a  less  erroneous 
one?  But  so  it  is  that  in  Homeopathic  works  and 
journals  and  gossip  one  can  never,  or  next  to  never, 
find  anything  but  successful  cases,  which  might  do 
very  well  as  a  proof  of  superior  skill,  did  it  not  prove 
as  much  for  the  swindling  advertisers  whose  certifi 
cates  disgrace  so  many  of  our  newspapers.  How  long 
will  it  take  mankind  to  learn  that  while  they  listen  to 
"the  speaking  hundreds  and  units,  who  make  the 
world  ring "  with  the  pretended  triumphs  they  have 
witnessed,  the  "dumb  millions"  of  deluded  and  in 
jured  victims  are  paying  the  daily  forfeit  of  their  mis 
placed  confidence ! 

I  am  sorry  to  see,  also,  that  a  degree  of  ignorance 
as  to  the  natural  course  of  diseases  is  often  shown  in 
these  published  cases,  which,  although  it  may  not  be 
detected  by  the  unprofessional  reader,  conveys  an  un 
pleasant  impression  to  those  who  are  acquainted  with 
the  subject.  Thus  a  young  woman  affected  with  jaun 
dice  is  mentioned  in  the  German  "  Annals  of  Clinical 
HomoBopathy"  as  having  been  cured  in  twenty-nine 
days  by  pulsatilla  and  mix  vomica.  Rummel,  a  well*- 
known  writer  of  the  same  school,  speaks  of  curing  a 
case  of  jaundice  in  thirty-four  days  by  Homoeopathic 
doses  of  pulsatilla,  aconite,  and  cinchona.  I  happened 
to  have  a  case  in  my  own  household,  a  few  weeks 
since,  which  lasted  about  ten  days,  and  this  was  longer 


HOMOEOPATHY   AND   ITS   KINDRED   DELUSIONS.      77 

than  I  have  repeatedly  seen  it  in  hospital  practice,  so 
that  it  was  nothing  to  boast  of. 

Dr.  Munneche  of  Lichtenburg  in  Saxony  is  called 
to  a  patient  with  sprained  ankle  who  had  been  a  fort 
night  under  the  common  treatment.  The  patient  gets 
well  by  the  use  of  arnica  in  a  little  more  than  a  month 
longer,  and  this  extraordinary  fact  is  published  in  the 
French  "  Archives  of  Homoaopathic  Medicine." 

In  the  same  Journal  is  recorded  the  case  of  a  patient 
who  with  nothing  more,  so  far  as  any  proof  goes,  than 
influenza,  gets  down  to  her  shop  upon  the  sixth  day. 

And  again,  the  cool  way  in  which  everything  favor 
able  in  a  case  is  set  down  by  these  people  entirely  to 
their  treatment,  may  be  seen  in  a  case  of  croup  re 
ported  in  the  "  Homoaopathic  Gazette  "  of  Leipsic,  in 
which  leeches,  blistering,  inhalation  of  hot  vapor,  and 
powerful  internal  medicine  had  been  employed,  and 
yet  the  merit  was  all  attributed  to  one  drop  of  some 
Homoaopathic  fluid. 

I  need  not  multiply  these  quotations,  which  illus 
trate  the  grounds  of  an  opinion  which  the  time  does 
not  allow  me  to  justify  more  at  length;  other  such 
cases  are  lying  open  before  me ;  there  is  no  end  to 
them  if  more  were  wanted ;  for  nothing  is  necessary 
but  to  look  into  any  of  the  numerous  broken-down 
Journals  of  Homoeopathy,  the  volumes  of  which  may 
be  found  on  the  shelves  of  those  curious  in  such  mat 
ters. 

A  number  of  public  trials  of  Homoeopathy  have 
been  made  in  different  parts  of  the  world.  Six  of 
these  are  mentioned  in  the  Manifesto  of  the  "  Homoe 
opathic  Examiner."  Now  to  suppose  that  any  trial 
can  absolutely  silence  people,  would  be  to  forget  the 
whole  experience  of  the  past.  Dr.  Haygarth  and  Dr. 


78  MEDICAL   ESSAYS. 

Alderson  could  not  stop  the  sale  of  the  five-guinea 
Tractors,  although  they  proved  that  they  could  work 
the  same  miracles  with  pieces  of  wood  and  tobacco- 
pipe.  It  takes  time  for  truth  to  operate  as  well  as 
Homoeopathic  globules.  Many  persons  thought  the  re 
sults  of  these  trials  were  decisive  enough  of  the  nul 
lity  of  the  treatment ;  those  who  wish  to  see  the  kind 
of  special  pleading  and  evasion  by  which  it  is  at 
tempted  to  cover  results  which,  stated  by  the  "  Homoe- 
opathic  Examiner  "  itself,  look  exceedingly  like  a  mis 
erable  failure,  may  consult  the  opening  flourish  of  that 
Journal.  I  had  not  the  intention  to  speak  of  these 
public  trials  at  all,  having  abundant  other  evidence  on 
the  point.  But  I  think  it  best,  on  the  whole,  to  men 
tion  two  of  them  in  a  few  words,  —  that  instituted  at 
Naples  and  that  of  Andral. 

There  have  been  few  names  in  the  medical  pro 
fession,  for  the  last  half  century,  so  widely  known 
throughout  the  world  of  science  as  that  of  M.  Esquirol, 
whose  life  was  devoted  to  the  treatment  of  insanity, 
and  who  was  without  a  rival  in  that  department  of 
practical  medicine.  It  is  from  an  analysis  communi 
cated  by  him  to  the  "  Gazette  Me*dicale  de  Paris  "  that 
I  derive  my  acquaintance  with  the  account  of  the  trial 
at  Naples  by  Dr.  Panvini,  physician  to  the  Hospital 
della  Pace.  This  account  seems  to  be  entirely  deserving 
of  credit.  Ten  patients  were  set  apart,  and  not  allowed 
to  take  any  medicine  at  all,  —  much  against  the  wish 
of  the  Homosopathic  physician.  All  of  them  got  well, 
and  of  course  all  of  them  would  have  been  claimed 
as  triumphs  if  they  had  been  submitted  to  the  treat 
ment.  Six  other  slight  cases  (each  of  which  is  speci 
fied)  got  well  under  the  Homoeopathic  treatment,  — 
none  of  its  asserted  specific  effects  being  manifested 


HOMCEOPATHY   AND   ITS   KINDRED   DELUSIONS.      79 

All  the  rest  were  cases  of  grave  disease ;  and  so  far  as 
the  trial,  which  was  interrupted  about  the  fortieth 
day,  extended,  the  patients  grew  worse,  or  received  no 
benefit.  A  case  is  reported  on  the  page  before  me  of 
a  soldier  affected  with  acute  inflammation  in  the  chest, 
who  took  successively  aconite,  bryonia,  mix  vomica, 
and  pulsatilla,  and  after  thirty-eight  days  of  treatment 
remained  without  any  important  change  in  his  disease. 
The  Homo30pathic  physician  who  treated  these  pa 
tients  was  M.  de  Horatiis,  who  had  the  previous  year 
been  announcing  his  wonderful  cures.  And  M.  Es- 
quirol  asserted  to  the  Academy  of  Medicine  in  1835, 
that  this  M.  de  Horatiis,  who  is  one  of  the  prominent 
personages  in  the  "  Examiner's  "  Manifesto  published 
in  1840,  had  subsequently  renounced  Homoeopathy.  I 
may  remark,  by  the  way,  that  this  same  periodical, 
which  is  so  very  easy  in  explaining  away  the  results  of 
these  trials,  makes  a  mistake  of  only  six  years  or  a 
little  more  as  to  the  time  when  this  at  Naples  was  in 
stituted. 

M.  Andral,  the  "  eminent  and  very  enlightened  allop 
athist "  of  the  "  Homoeopathic  Examiner,"  made  the  fol 
lowing  statement  in  March,  1835,  to  the  Academy  of 
Medicine :  "I  have  submitted  this  doctrine  to  experi 
ment  ;  I  can  reckon  at  this  time  from  one  hundred  and 
thirty  to  one  hundred  and  forty  cases,  recorded  with 
perfect  fairness,  in  a  great  hospital,  under  the  eye  of 
numerous  witnesses;  to  avoid  every  objection  I  ob 
tained  my  remedies  of  M.  Guibourt,  who  keeps  a 
Homoeopathic  pharmacy,  and  whose  strict  exactness 
is  well  known;  the  regimen  has  been  scrupulously 
observed,  and  I  obtained  from  the  sisters  attached  to 
the  hospital  a  special  regimen,  such  as  Hahnemann 
orders.  I  was  told,  however,  some  months  since,  that 


80  MEDICAL  ESSAYS. 

I  had  not  been  faithful  to  all  the  rules  of  the  doctrine 
I  therefore  took  the  trouble  to  begin  again;  I  have 
studied  the  practice  of  the  Parisian  HonuEopathists, 
as  I  had  studied  their  books,  and  I  became  convinced 
that  they  treated  their  patients  as  I  had  treated  mine, 
and  I  affirm  that  I  have  been  as  rigorously  exact  in 
the  treatment  as  any  other  person." 

And  he  expressly  asserts  the  entire  nullity  of  the 
influence  of  all  the  Homoeopathic  remedies  tried  by 
him  in  modifying,  so  far  as  he  could  observe,  the  prog 
ress  or  termination  of  diseases.  It  deserves  notice 
that  he  experimented  with  the  most  boasted  sub 
stances, —  cinchona,  aconite,  mercury,  bryonia,  bella 
donna.  Aconite,  for  instance,  he  says  he  administered 
in  more  than  forty  cases  of  that  collection  of  feverish 
symptoms  in  which  it  exerts  so  much  power,  according 
to  Hahnemann,  and  in  not  one  of  them  did  it  have 
the  slightest  influence,  the  pulse  and  heat  remaining 
as  before. 

These  statements  look  pretty  honest,  and  would 
seem  hard  to  be  explained  away,  but  it  is  calmly  said 
that  he  "  did  not  know  enough  of  the  method  to  select 
the  remedies  with  any  tolerable  precision.""  Who 
are  they  that  practice  Homoeopathy,  and  say  this  of  a 
man  with  the  Materia  Medica  of  Hahnemann  lying 
before  him?  Who  are  they  that  send  these  same 
globules,  on  which  he  experimented,  accompanied  by 
a  little  book,  into  families,  whose  members  are  thought 
competent  to  employ  them,  when  they  deny  any  such 

•  Homoeopathic  Examiner,  vol.  i.  p.  22. 

"  Nothing  is  left  to  the  caprice  of  the  physician.  ('  In  a  word, 
Instead  of  being  dependent  upon  blind  chance,  that  there  is  an 
infallible  law,  guided  by  which;  the  physician  MUST  select  the 
proper  remedies.')  "  Ibid.,  in  a  notice  of  Menzel's  paper. 


HOMCEOPATHY  AND  ITS   KINDRED   DELUSIONS.      81 

capacity  to  a  man  whose  life  has  been  passed  at  the 
bedside  of  patients,  the  most  prominent  teacher  in  the 
first  Medical  Faculty  in  the  world,  the  consulting  phy 
sician  of  the  King  of  France,  and  one  of  the  most 
renowned  practical  writers,  not  merely  of  his  nation, 
but  of  his  age  ?  I  leave  the  quibbles  by  which  such 
persons  would  try  to  creep  out  from  under  the  crushing 
weight  of  these  conclusions  to  the  unfortunates  who 
suppose  that  a  reply  is  equivalent  to  an  answer. 

Dr.  Baillie,  one  of  the  physicians  in  the  great  H<5tel 
Dieu  of  Paris,  invited  two  Homoeopathic  practitioners 
to  experiment  in  his  wards.  One  of  these  was  Curie, 
now  of  London,  whose  works  are  on  the  counters  of 
some  of  our  bookstores,  and  probably  in  the  hands  of 
some  of  my  audience.  This  gentleman,  whom  Dr. 
Baillie  declares  to  be  an  enlightened  man,  and  per 
fectly  sincere  in  his  convictions,  brought  his  own 
medicines  from  the  pharmacy  which  furnished  Hah- 
nemann  himself,  and  employed  them  for  four  or  five 
months  upon  patients  in  his  ward,  and  with  results 
equally  unsatisfactory,  as  appears  from  Dr.  Baillie's 
statement  at  a  meeting  of  the  Academy  of  Medicine. 
And  a  similar  experiment  was  permitted  by  the  Clin 
ical  Professor  of  the  H6tel  Dieu  of  Lyons,  with  the 
same  complete  failure. 

But  these  are  old  and  prejudiced  practitioners. 
Very  well,  then  take  the  statement  of  Dr.  Fleury,  a 
most  intelligent  young  physician,  who  treated  homoeo- 
pathically  more  than  fifty  patients,  suffering  from  dis 
eases  which  it  was  not  dangerous  to  treat  in  this  way, 
taking  every  kind  of  precaution  as  to  regimen,  removal 
of  disturbing  influences,  and  the  state  of  the  atmos 
phere,  insisted  upon  by  the  most  vigorous  partisans 
of  the  doctrine,  and  found  not  the  slightest  effect  pro- 


82  MEDICAL  ESSAYS. 

duced  by  the  medicines.  And  more  than  this,  read 
nine  of  these  cases,  which  he  has  published,  as  I  have 
just  done,  and  observe  the  absolute  nullity  of  aconite, 
belladonna,  and  bryonia,  against  the  symptoms  over 
which  they  are  pretended  to  exert  such  palpable,  such 
obvious,  such  astonishing  influences.  In  the  view  of 
these  statements,  it  is  impossible  not  to  realize  the  en 
tire  futility  of  attempting  to  silence  this  asserted  sci 
ence  by  the  flattest  and  most  peremptory  results  of 
experiment.  Were  all  the  hospital  physicians  of  Eu 
rope  and  America  to  devote  themselves,  for  the  requi 
site  period,  to  this  sole  pursuit,  and  were  their  results 
to  be  unanimous  as  to  the  total  worthlessness  of  the 
whole  system  in  practice,  this  slippery  delusion  would 
slide  through  their  fingers  without  the  slightest  discom 
posure,  when,  as  they  supposed,  they  had  crushed  every 
joint  in  its  tortuous  and  trailing  body. 

3.  I  have  said,  that  to  show  the  truth  of  the  Ho- 
moaopathic  doctrine,  as  announced  by  Hahnemann,  it 
would  be  necessary  to  show,  in  the  third  place,  that 
remedies  never  cure  diseases  when  they  are  not  capa 
ble  of  producing  similar  symptoms.  The  burden  of 
this  somewhat  comprehensive  demonstration  lying  en 
tirely  upon  the  advocates  of  this  doctrine,  it  may  be 
left  to  their  mature  reflections. 

It  entered  into  my  original  plan  to  treat  of  the  doc 
trine  relating  to  Psora,  or  itch,  —  an  almost  insane 
conception,  which  I  am  glad  to  get  rid  of,  for  this  is  a 
subject  one  does  not  care  to  handle  without  gloves. 
I  am  saved  this  trouble,  however,  by  finding  that 
many  of  the  disciples  of  Hahnemann,  those  disciples 
the  very  gospel  of  whose  faith  stands  upon  his  word, 


HOMOEOPATHY   AND   ITS  KINDRED   DELUSIONS.      83 

make  very  light  of  his  authority  on  this  point,  although 
he  himself  says,  "  It  has  cost  me  twelve  years  of  study 
and  research  to  trace  out  the  source  of  this  incredible 
number  of  chronic  affections,  to  discover  this  great 
truth,  which  remained  concealed  from  all  my  prede 
cessors  and  contemporaries,  to  establish  the  basis  of 
its  demonstration,  and  find  out,  at  the  same  time,  the 
curative  medicines  that  were  fit  to  combat  this  hydra 
in  all  its  different  forms." 

But,  in  the  face  of  all  this,  the  following  remarks 
are  made  by  Wolff,  of  Dresden,  whose  essays,  accord 
ing  to  the  editor  of  the  "Homoeopathic  Examiner,'* 
"  represent  the  opinions  of  a  large  majority  of  Homce- 
opathists  in  Europe." 

"  It  cannot  be  unknown  to  any  one  at  all  familiar 
with  Homo3opathic  literature,  that  Hahnemann's  idea 
of  tracing  the  large  majority  of  chronic  diseases  to 
actual  itch  has  met  with  the  greatest  opposition  from 
Homoaopathic  physicians  themselves."  And  again, 
"  If  the  Psoric  theory  has  led  to  no  proper  schism,  the 
reason  is  to  be  found  in  the  fact  that  it  is  almost  with 
out  any  influence  in  practice." 

We  are  told  by  Jahr,  that  Dr.  Griesselich,  "  Sur 
geon  to  the  Grand  Duke  of  Baden,"  and  a  "  distin 
guished"  Homceopathist,  actually  asked  Hahnemann 
for  the  proof  that  chronic  diseases,  such  as  dropsy,  for 
instance,  never  arise  from  any  other  cause  than  itch ; 
and  that,  according  to  common  report,  the  venerable 
sage  was  highly  incensed  (fort  courroucf)  with  Dr. 
Hartmann,  of  Leipsic,  another  "  distinguished "  Ho- 
moeopathist,  for  maintaining  that  they  certainly  did 
arise  from  other  causes. 

And  Dr.  Fielitz,  in  the  "  Homoeopathic  Gazette"  of 
Leipsic,  after  saying,  in  a  good-natured  way,  that 


84  MEDICAL   ESSAYS. 

Psora  is  the  Devil  in  medicine,  and  that  physicians 
are  divided  on  this  point  into  diabolists  and  exorcists, 
declares  that,  according  to  a  remark  of  Hahnemann, 
the  whole  civilized  world  is  affected  with  Psora.  I 
must  therefore  disappoint  any  advocate  of  Hahnemann 
who  may  honor  me  with  his  presence,  by  not  attacking 
a  doctrine  on  which  some  of  the  disciples  of  his  creed 
would  be  very  happy  to  have  its  adversaries  waste 
their  time  and  strength.  I  will  not  meddle  with  this 
excrescence,  which,  though  often  used  in  time  of  peace, 
would  be  dropped,  like  the  limb  of  a  shell-fish,  the  mo 
ment  it  was  assailed ;  tune  is  too  precious,  and  the 
harvest  of  living  extravagances  nods  too  heavily  to  my 
sickle,  that  I  should  blunt  it  upon  straw  and  stubble. 


I  will  close  the  subject  with  a  brief  examination  of 
some  of  the  statements  made  in  Homoeopathic  works, 
and  more  particularly  in  the  brilliant  Manifesto  of  the 
"Examiner,"  before  referred  to.  And  first,  it  is  there 
stated  under  the  head  of  "  Homoeopathic  Literature," 
that  "  SEVEN  HUNDRED  volumes  have  been  issued 
from  the  press  developing  the  peculiarities  of  the  sys 
tem,  and  many  of  them  possessed  of  a  scientific  char 
acter  that  savans  know  well  how  to  respect."  If  my 
assertion  were  proper  evidence  in  the  case,  I  should 
declare,  that,  having  seen  a  good  many  of  these  publi 
cations,  from  the  year  1834,  when  I  bought  the  work 
of  the  Rev.  Thomas  Everest,"  to  within  a  few  weeks, 
when  I  received  my  last  importation  of  Homoeopathic 
literature,  I  have  found  that  all,  with  a  very  few  ex- 

•  Dr.  Curie  speaks  of  this  silly  pamphlet  as  having  been  pub 
lished  in  1835. 


HOM(EOPATHY   AND   ITS   KINDRED   DELUSIONS.      85 

ceptions,  were  stitched  pamphlets  varying  from  twenty 
or  thirty  pages  to  somewhat  less  than  a  hundred,  and 
generally  resembling  each  other  as  much  as  so  many 
spelling-books. 

But  not  being  evidence  in  the  case,  I  will  give  you 
the  testimony  of  Dr.  Trinks,  of  Dresden,  who  flour 
ishes  on  the  fifteenth  page  of  the  same  Manifesto  as 
one  of  the  most  distinguished  among  the  Homoeopa- 
thists  of  Europe.  I  translate  the  sentence  literally 
from  the  "  Archives  de  la  Me'decine  Homoeopathique." 

"  The  literature  of  Homoeopathy,  if  that  honorable 
name  must  be  applied  to  all  kinds  of  book-making,  has 
been  degraded  to  the  condition  of  the  humblest  servi 
tude.  Productions  without  talent,  without  spirit,  with 
out  discrimination,  flat  and  pitiful  eulogies,  exaggera 
tions  surpassing  the  limits  of  the  most  robust  faith, 
invectives  against  such  as  dared  to  doubt  the  dogmas 
which  had  been  proclaimed,  or  catalogues  of  remedies ; 
of  such  materials  is  it  composed !  From  distance  to 
distance  only,  have  appeared  some  memoirs  useful  to 
science  or  practice,  which  appear  as  so  many  green 
oases  in  the  midst  of  this  literary  desert." 

It  is  a  very  natural  as  well  as  a  curious  question  to 
ask,  What  has  been  the  success  of  Homosopathy  in  the 
different  countries  of  Europe,  and  what  is  its  present 
condition  ? 

The  greatest  reliance  of  the  advocates  of  Homoeopa 
thy  is  of  course  on  Germany.  We  know  very  little  of 
its  medical  schools,  its  medical  doctrines,  or  its  medi 
cal  men,  compared  with  those  of  England  and  France. 
And,  therefore,  when  an  intelligent  traveller  gives  a 
direct  account  from  personal  inspection  of  the  misera 
ble  condition  of  the  Homoeopathic  hospital  at  Leipsic, 
the  first  established  in  Europe,  and  the  first  on  the  list 


86  MEDICAL  ESSAYS. 

of  the  ever-memorable  Manifesto,  it  is  easy  enough  to 
answer  or  elude  the  fact  by  citing  various  hard  names 
of  "  distinguished  "  practitioners,  which  sound  just  as 
well  to  the  uninformed  public  as  if  they  were  Meckel, 
or  Tiedemann,  or  Langenbeck.  Dr.  Leo- Wolf,  who, 
to  be  sure,  is  opposed  to  Homoeopathy,  but  who  is  a 
scholar,  and  ought  to  know  something  of  his  own  coun 
trymen,  assures  us  that  "  Dr.  Kopp  is  the  only  Ger 
man  Homoeopathist,  if  we  can  call  him  so,  who  has 
been  distinguished  as  an  author  and  practitioner  be 
fore  he  examined  this  method."  And  Dr.  Lee,  the 
same  gentleman  in  whose  travels  the  paragraph  relat 
ing  to  the  Leipsic  Hospital  is  to  be  found,  says  the 
same  thing.  And  I  will  cheerfully  expose  myself  to 
any  impertinent  remark  which  it  might  suggest,  to  as 
sure  my  audience  that  I  never  heard  or  saw  one  au 
thentic  Homoaopathic  name  of  any  country  in  Europe, 
which  I  had  ever  heard  mentioned  before  as  connected 
with  medical  science  by  a  single  word  or  deed  suffi 
cient  to  make  it  in  any  degree  familiar  to  my  ears, 
unless  Arnold  of  Heidelberg  is  the  anatomist  who  dis 
covered  a  little  nervous  centre,  called  the  otic  ganglion. 
But  you  need  ask  no  better  proof  of  who  and  what  the 
German  adherents  of  this  doctrine  must  be,  than 
the  testimony  of  a  German  Homoeopathist  as  to  the 
wretched  character  of  the  works  they  manufacture  to 
enforce  its  claims. 

As  for  the  act  of  this  or  that  government  tolerating 
or  encouraging  Homoeopathy,  every  person  of  common 
intelligence  knows  that  it  is  a  mere  form  granted  or 
denied  according  to  the  general  principles  of  policy 
adopted  in  different  states,  or  the  degree  of  influence 
which  some  few  persons  who  have  adopted  it  may  hap 
pen  to  have  at  court.  What  may  be  the  value  of  cer- 


HOMOEOPATHY   AND   ITS    KINDRED   DELUSIONS.      87 

tain  pompous  titles  with  which  many  of  the  advocates 
of  Homoeopathy  are  honored,  it  might  be  disrespectful 
to  question.  But  in  the  mean  time  the  judicious  in 
quirer  may  ponder  over  an  extract  which  I  translate 
from  a  paper  relating  to  a  personage  well  known  to 
the  community  as  Williams  the  Oculist,  with  whom 
I  had  the  honor  of  crossing  the  Atlantic  some  years 
since,  and  who  himself  handed  me  two  copies  of  the 
paper  in  question. 

"  To  say  that  he  was  oculist  of  Louis  XVIII.  and  of 
Charles  X.,  and  that  he  now  enjoys  the  same  title  with 
respect  to  His  Majesty,  Louis  Philippe,  and  the  King 
of  the  Belgians,  is  unquestionably  to  say  a  great  deal ; 
and  yet  it  is  one  of  the  least  of  his  titles  to  public  con 
fidence.  His  reputation  rests  upon  a  basis  more  sub 
stantial  even  than  the  numerous  diplomas  with  which 
he  is  provided,  than  the  membership  of  the  different 
medical  societies  which  have  chosen  him  as  their  asso 
ciate,"  etc.,  etc. 

And  as  to  one  more  point,  it  is  time  that  the  public 
should  fully  understand  that  the  common  method  of 
supporting  barefaced  imposture  at  the  present  day, 
both  in  Europe  and  in  this  country,  consists  in  trump 
ing  up  "  Dispensaries,"  "  Colleges  of  Health,"  and  other 
advertising  charitable  clap-traps,  which  use  the  poor 
as  decoy-ducks  for  the  rich,  and  the  proprietors  of 
which  have  a  strong  predilection  for  the  title  of  "  Pro 
fessor."  These  names,  therefore,  have  come  to  be  of 
Uttle  or  no  value  as  evidence  of  the  good  character, 
still  less  of  the  high  pretensions  of  those  who  invoke 
their  authority.  Nor  does  it  follow,  even  when  a  chair 
is  founded  in  connection  with  a  well-known  institution, 
that  it  has  either  a  salary  or  an  occupant ;  so  that  it 
may  be,  and  probably  is,  a  mere  harmless  piece  of  tol- 


88  MEDICAL  ESSAYS. 

eration  on  the  part  of  the  government  if  a  Professor- 
ship  of  Homoeopathy  is  really  in  existence  at  Jena  01 
Heidelberg.  And  finally,  in  order  to  correct  the  error 
of  any  who  might  suppose  that  the  whole  Medical  Pro 
fession  of  Germany  has  long  since  fallen  into  the  de 
lusions  of  Hahnemann,  I  will  quote  two  lines  which  a 
celebrated  anatomist  and  surgeon  (whose  name  will 
occur  again  in  this  lecture  in  connection  with  a  very 
pleasing  letter)  addressed  to  the  French  Academy  of 
Medicine  in  1835.  "I  happened  to  be  in  Germany 
some  months  since,  at  a  meeting  of  nearly  six  hundred 
physicians ;  one  of  them  wished  to  bring  up  the  ques 
tion  of  Homoaopathy;  they  would  not  even  listen  to 
him."  This  may  have  been  very  impolite  and  bigoted, 
but  that  is  not  precisely  the  point  in  reference  to  which 
I  mention  the  circumstance. 

But  if  we  cannot  easily  get  at  Germany,  we  can 
very  easily  obtain  exact  information  from  France  and 
England.  I  took  the  trouble  to  write  some  months 
ago  to  two  friends  in  Paris,  in  whom  I  could  place 
confidence,  for  information  upon  the  subject.  One  of 
them  answered  briefly  to  the  effect  that  nothing  was 
said  about  it.  When  the  late  Curator  of  the  Low 
ell  Institute,  at  his  request,  asked  about  the  works 
upon  the  subject,  he  was  told  that  they  had  remained 
a  long  time  on  the  shelves  quite  unsalable,  and  never 
spoken  of. 

The  other  gentleman,"  whose  name  is  well  known  to 
my  audience,  and  who  needs  no  commendation  of  mine, 
had  the  kindness  to  procure  for  me  many  publications 
upon  the  subject,  and  some  information  which  sets  the 
whole  matter  at  rest,  so  far  as  Paris  is  concerned.  He 

a  Dr.  Henry  J.  Bigelow,  now  Professor  of  Surgery  in  Hap 
vard  University. 


HOMffiOPATHY   AND   ITS   KINDRED    DELUSIONS.      89 

went  directly  to  the  Bailli&res,  the  principal  and  al 
most  the  only  publishers  of  all  the  Homosopathic 
books  and  journals  in  that  city.  The  following  facts 
were  taken  by  him  from  the  account-books  of  this  pub 
lishing  firm.  Four  Homoeopathic  Journals  have  been 
published  in  Paris  ;  three  of  them  by  the  Baillieres. 

The  reception  they  met  with  may  be  judged  of  by 
the  following  list,  showing  the  number  of  subscribers 
to  each  on  the  books  of  the  publishing  firm  in  Paris 
during  several  successive  years :  — 

Tear.     Subscribers. 

1.  Bibliotheque  ffomosopathique     .     .  1833     129 

"  1835  80 

"  1837  72 

"  "  1839  55 

"  1841  31 

2.  Archives  de  la  MSdecine  ffomoeopa 

thique      1834     186 

"  1836     175 

"  1838     148 

Changed  its  name  to  Journal  de  la 

Doctrine  ffahnemanienne,  in    .     .  1840     114 

Ceased  to  be  published. 
8.  Revue  Critique  et  Retrospective  de 

la  Matiere  Medicale, 1840       65 

1841      51 

4.  A  Review  published  by  some  other  house,  which 
lasted  one  year,  and  had  about  fifty  subscribers, 
appeared  in  1834,  1835. 

These  are  the  only  four  Journals  of  Homoeopathy 
ever  published  in  Paris.  The  Baillidres  informed  my 
correspondent  that  the  sale  of  Homoeopathic  books  was 
much  less  than  formerly,  and  that  consequently  they 
should  undertake  to  publish  no  new  books  upon  the 


90  MEDICAL   ESSAYS. 

subject,  except  those  of  Jahr  or  Hahnemann.  "  This 
man,"  says  my  correspondent,  — referring  to  one  of 
the  brothers,  —  "  the  publisher  and  headquarters  of 
Homoeopathy  in  Paris,  informs  me  that  it  is  going 
down  in  England  and  Germany  as  well  as  in  Paris." 
For  all  the  facts  he  had  stated  he  pledged  himself  as 
responsible. 

Homosopathy  was  in  its  prune  in  Paris,  he  said,  in 
1836  and  1837,  and  since  then  has  been  going  down. 

Louis  told  my  correspondent  that  no  person  of  dis 
tinction  in  Paris  had  embraced  Homoeopathy,  and  that 
it  was  declining.  If  you  ask  who  Louis  is,  I  refer 
you  to  the  well-known  Homo3opathist,  Peschier  of  Ge 
neva,  who  says,  addressing  him,  "  I  respect  no  one 
more  than  yourself  ;  the  feeling  which  guides  your  re 
searches,  your  labors,  and  your  pen,  is  so  honorable 
and  rare,  that  I  could  not  but  bow  down  before  it ; 
and  I  own,  if  there  were  any  allopathist  who  inspired 
me  with  higher  veneration,  it  would  be  him  and  not 
yourself  whom  I  should  address." 

Among  the  names  of  "Distinguished  Homoeopa- 
thists,"  however,  displayed  in  imposing  columns,  in 
the  index  of  the  "  Homeopathic  Examiner,"  are  those 
of  MARJOLIN,  AMUSSAT,  and  BRESCHET,  names  well 
known  to  the  world  of  science,  and  the  last  of  them 
identified  with  some  of  the  most  valuable  contribu 
tions  which  anatomical  knowledge  has  received  since 
the  commencement  of  the  present  century.  One  Dr. 
Croserio,0  who  stands  sponsor  for  -many  facts  in  that 
Journal,  makes  the  following  statement  among  the 
rest :  "  Professors,  who  are  esteemed  among  the  most 

0  This  gentleman's  distinction  is  vouched  for  by  Dr.  F.  Hart- 
mann  of  Leipsic.  Dr.  Hartmann's  distinction  is  certified  by  the 
editor  of  the  Homeopathic  Examiner. 


HOM(EOPATHT   AND   ITS   KINDRED   DELUSIONS.       91 

distinguished  of  the  Faculty  (FacultS  de  VEcole  de 
Medecine),  both  as  to  knowledge  and  reputation,  have 
openly  confessed  the  power  of  Homoeopathia  in  forms 
of  disease  where  the  ordinary  method  of  practice 
proved  totally  insufficient.  It  affords  me  the  highest 
pleasure  to  select  from  among  these  gentlemen,  Mar- 
jolin,  Amussat,  and  Breschet." 

Here  is  a  literal  translation  of  an  original  Ietter9 
now  in  my  possession,  from  one  of  these  Homoeopa- 
thists  to  my  correspondent :  — 

"  DEAR  SIR,  AND  RESPECTED  PROFESSIONAL  BROTHER  ;  — 

"  You  have  had  the  kindness  to  inform  me  in  your 
letter  that  a  new  American  Journal,  the  '  New  World,' a 
has  made  use  of  my  name  in  support  of  the  pretended 
Homoeopathic  doctrines,  and  that  I  am  represented  as 
one  of  the  warmest  partisans  of  Homoeopathy  hi 
France. 

"  I  am  vastly  surprised  at  the  reputation  manufac 
tured  for  me  upon  the  new  continent ;  but  I  am 
obliged,  in  deference  to  truth,  to  reject  it  with  my 
whole  energy.  I  spurn  far  from  me  everything  which 
relates  to  that  charlatanism  called  Homoeopathy,  for 
these  pretended  doctrines  cannot  endure  the  scrutiny 
of  wise  and  enlightened  persons,  who  are  guided  by 
honorable  sentiments  in  the  practice  of  the  noblest  of 
arts.  "  I  am,  etc.,  etc., 

"  G.  BRESCHET, 

"  Professor  in  the  Faculty  of  Medicine, 
Member  of  the  Institute,  Surgeon  of 
Hotel  Dieu,  and  Consulting  Surgeon 
to  the  King,  etc. 
"PARIS,  3d  November,  1841." 

"  I  first  saw  M.  Breschet's  name  mentioned  in  that  Journal. 


92  MEDICAL   ESSAYS. 

Concerning  Amussat,  my  correspondent  writes,  that 
he  was  informed  by  Madame  Hahnemann,  who  con 
verses  in  French  more  readily  than  her  husband,  and 
therefore  often  speaks  for  him,  that  "  he  was  not  a 
physician,  neither  Homoeopathist  nor  AUopathist,  but 
that  he  was  the  surgeon  of  their  own  establishment ; 
that  is,  performed  as  a  surgeon  all  the  operations  they 
had  occasion  for  in  their  practice." 

I  regret  not  having  made  any  inquiries  as  to  Mar- 
jolin,  who,  I  doubt  not,  would  strike  his  ponderous 
snuff-box  until  it  resounded  like  the  Grecian  horse,  at 
hearing  such  a  doctrine  associated  with  his  respectable 
name.  I  was  not  aware,  when  writing  to  Paris,  that 
this  worthy  Professor,  whose  lectures  I  long  attended, 
was  included  hi  these  audacious  claims  ;  but  after  the 
specimens  I  have  given  of  the  accuracy  of  the  foreign 
correspondence  of  the  "  Homoeopathic  Examiner,"  any 
further  information  I  might  obtain  would  seem  so  su 
perfluous  as  hardly  to  be  worth  the  postage. 

Homoeopathy  may  be  said,  then,  to  be  in  a  suffi 
ciently  miserable  condition  in  Paris.  Yet  there  lives, 
and  there  has  lived  for  years,  the  illustrious  Samuel 
Hahnemann,  who  himself  assured  my  correspondent 
that  no  place  offered  the  advantages  of  Paris  in  its 
investigation,  by  reason  of  the  attention  there  paid  to 
it. 

In  England,  it  appears  by  the  statement  of  Dr. 
Curie  in  October,  1839,  about  eight  years  after  its  in 
troduction  into  the  country,  that  there  were  eighteen 
Homoeopathic  physicians  in  the  United  Kingdom,  of 
whom  only  three  were  to  be  found  out  of  London,  and 
that  many  of  these  practised  Homoeopathy  in  secret. 

It  will  be  seen,  therefore,  that,  according  to  the  re« 
cent  statement  of  one  of  its  leading  English  advocates, 


HOMCEOPATHT   AND   ITS   KINDRED   DELUSIONS.      93 

Homoeopathy  had  obtained  not  quite  half  as  many 
practical  disciples  in  England  as  Perkinism  could  show 
for  itself  in  a  somewhat  less  period  from  the  time  of 
its  first  promulgation  in  that  country. 

Dr.  Curie's  letter,  dated  London,  October  30,  1839, 
says  there  is  "  one  in  Dublin,  Dr.  Luther ;  at  Glas 
gow,  Dr.  Scott."  The  "  distinguished  "  Croserio  writes 
from  Paris,  dating  October  20,  1839,  "  On  the  other 
hand,  Homoeopathy  is  commencing  to  make  an  inroad 
into  England  by  the  way  of  Ireland.  At  Dublin,  dis 
tinguished  physicians  have  already  embraced  the  new 
system,  and  a  great  part  of  the  nobility  and  gentry 
of  that  city  have  emancipated  themselves  from  the 
English  fashion  and  professional  authority." 

But  the  Marquis  of  Anglesea  and  Sir  Edward  Lyt- 
ton  Bulwer  patronize  Homoeopathy ;  the  Queen  Dow 
ager  Adelaide  has  been  treated  by  a  Homoeopathic 
physician.  "  Jarley  is  the  delight  of  the  nobility  and 
gentry."  "  The  Royal  Family  are  the  patrons  of  Jar- 
ley." 

Let  me  ask  if  a  Marquis  and  a  Knight  are  better 
than  two  Lords,  and  if  the  Dowager  of  Royalty  is 
better  than  Royalty  itself,  all  of  which  illustrious  dig 
nities  were  claimed  in  behalf  of  Benjamin  Douglass 
Perkins  ? 

But  if  the  balance  is  thought  too  evenly  suspended 
in  this  case,  another  instance  can  be  given  in  which 
the  evidence  of  British  noblemen  and  their  ladies  is 
shown  to  be  as  valuable  in  establishing  the  character 
of  a  medical  man  or  doctrine,  as  would  be  the  testi 
mony  of  the  Marquis  of  Waterford  concerning  the 
present  condition  and  prospects  of  missionary  enter 
prise.  I  have  before  me  an  octavo  volume  of  more 
than  four  hundred  pages,  in  which,  among  much  sim- 


94  MEDICAL   ESSAYS. 

ilar  matter,  I  find  highly  commendatory  letters  from 
the  Marchioness  of  Ormond,  Lady  Harriot  Kava- 
nagh,  the  Countess  of  Buckinghamshire,  the  Right 
Hon.  Viscount  Ingestre,  M.  P.,  and  the  Most  Noble, 
the  Marquis  of  Sligo,  —  all  addressed  to  "  John  St. 
John  Long,  Esq.,"  a  wretched  charlatan,  twice  tried 
for,  and  once  convicted  of,  manslaughter  at  the  Old 
Bailey. 

This  poor  creature,  too,  like  all  of  his  tribe,  speaks 
of  the  medical  profession  as  a  great  confederation  of 
bigoted  monopolists.  He,  too,  says  that  "  If  an  inno 
vator  should  appear,  holding  out  hope  to  those  in 
despair,  and  curing  disorders  which  the  faculty  have 
recorded  as  irremediable,  he  is  at  once,  and  without 
inquiry,  denounced  as  an  empiric  and  an  impostor." 
He,  too,  cites  the  inevitable  names  of  Galileo  and 
Harvey,  and  refers  to  the  feelings  excited  by  the  great 
discovery  of  Jenner.  From  the  treatment  of  the  great 
astronomer  who  was  visited  with  the  punishment  of 
other  heretics  by  the  ecclesiastical  authorities  of  a 
Catholic  country  some  centuries  since,  there  is  no  very 
direct  inference  to  be  drawn  to  the  medical  profession 
of  the  present  time.  His  name  should  be  babbled  no 
longer,  after  having  been  placarded  for  the  hundredth 
time  in  the  pages  of  St.  John  Long.  But  if  we  are 
doomed  to  see  constant  reference  to  the  names  of  Har 
vey  and  Jenner  in  every  worthless  pamphlet  contain 
ing  the  prospectus  of  some  new  trick  upon  the  public, 
let  us,  once  for  all,  stare  the  facts  in  the  face,  and  see 
how  the  discoveries  of  these  great  men  were  actually 
received  by  the  medical  profession. 

In  1628,  Harvey  published  his  first  work  upon  the 
circulation.  His  doctrines  were  a  complete  revolution 
of  the  prevailing  opinions  of  all  antiquity.  They  im- 


HOMCEOPATHT  AND  ITS  KINDRED  DELUSIONS.    95 

mediately  found  both  champions  and  opponents ;  of 
which  last,  one  only,  Riolanus,  seemed  to  Harrey 
worthy  of  an  answer,  on  account  of  his  "  rank,  fame, 
and  learning."  Controversy  in  science,  as  in  religion, 
was  not,  in  those  days,  carried  on  with  all  the  courtesy 
which  our  present  habits  demand,  and  it  is  possible 
that  some  hard  words  may  have  been  applied  to  Har 
vey,  as  it  is  very  certain  that  he  used  the  most  con 
temptuous  expressions  towards  others. 

Harvey  declares  in  his  second  letter  to  Riolanus, 
"  Since  the  first  discovery  of  the  circulation,  hardly  a 
day,  or  a  moment,  has  passed  without  my  hearing  it 
both  well  and  ill  spoken  of  ;  some  attack  it  with  great 
hostility,  others  defend  it  with  high  encomiums ;  one 
party  believe  that  I  have  abundantly  proved  the  truth 
of  the  doctrine  against  all  the  weight  of  opposing  ar 
guments,  by  experiments,  observations,  and  dissec 
tions  ;  others  think  it  not  yet  sufficiently  cleared  up, 
and  free  from  objections."  Two  really  eminent  Pro 
fessors,  Plempius  of  Louvain,  and  WalaBus  of  Ley- 
den,  were  among  its  early  advocates. 

The  opinions  sanctioned  by  the  authority  of  long 
ages,  and  the  names  of  Hippocrates  and  Galen,  dis 
solved  away,  gradually,  but  certainly,  before  the  dem 
onstrations  of  Harvey.  Twenty-four  years  after  the 
publication  of  his  first  work,  and  six  years  before  his 
death,  his  bust  in  marble  was  placed  in  the  Hall  of 
the  College  of  Physicians,  with  a  suitable  inscription 
recording  his  discoveries. 

Two  years  after  this  he  was  unanimously  invited  to 
accept  the  Presidency  of  that  body ;  and  he  lived  to 
see  his  doctrine  established,  and  all  reputable  opposi 
tion  withdrawn. 

There  were  many  circumstances  connected  with  the 


96  MEDICAL  ESSAYS. 

discovery  of  Dr.  Jenner  which  were  of  a  nature  to  ex. 
cite  repugnance  and  opposition.  The  practice  of  in 
oculation  for  the  small-pox  had  already  disarmed  that 
disease  of  many  of  its  terrors.  The  introduction  of  a 
contagious  disease  from  a  brute  creature  into  the  hu 
man  system  naturally  struck  the  public  mind  with  a 
sensation  of  disgust  and  apprehension,  and  a  part  of 
the  medical  public  may  have  shared  these  feelings. 
I  find  that  Jenner's  discovery  of  vaccination  was  made 
public  in  June,  1798.  In  July  of  the  same  year  the 
celebrated  surgeon,  Mr.  Cline,  vaccinated  a  child  with 
virus  received  from  Dr.  Jenner,  and  in  communicating 
the  success  of  this  experiment,  he  mentions  that  Dr. 
Lister,  formerly  of  the  Small-Pox  Hospital,  and  him 
self,  are  convinced  of  the  efficacy  of  the  cow-pox.  In 
November  of  the  same  year,  Dr.  Pearson  published 
his  "  Inquiry,"  containing  the  testimony  of  numerous 
practitioners  in  different  parts  of  the  kingdom,  to  the 
efficacy  of  the  practice.  Dr.  HAYGARTH,  who  was  so 
conspicuous  in  exposing  the  follies  of  Perkinism,  was 
among  the  very  earliest  to  express  his  opinion  in  favor 
of  vaccination.  In  1801,  Dr.  Lettsom  mentions  the 
circumstance  "  as  being  to  the  honor  of  the  medical 
professors,  that  they  have  very  generally  encouraged 
this  salutary  practice,  although  it  is  certainly  calcu 
lated  to  lessen  their  pecuniary  advantages  by  its  ten 
dency  to  extirpate  a  fertile  source  of  professional  prac 
tice." 

In  the  same  year  the  Medical  Committee  of  Paris 
spoke  of  vaccination  in  a  public  letter,  as  "  the  most 
brilliant  and  most  important  discovery  of  the  eight 
eenth  century."  The  Directors  of  a  Society  for  the 
Extermination  of  the  Small-Pox,  in  a  Report  dated 
October  1st,  1807,  "  congratulate  the  public  on  the 


HOM(EOPATHY   AND   ITS  KINDRED   DELUSIONS.      97 

very  favorable  opinion  which  the  Royal  College  of 
Physicians  of  London,  after  a  most  minute  and  labo 
rious  investigation  made  by  the  command  of  his  Maj 
esty,  have  a  second  time  expressed  on  the  subject  of 
vaccination,  in  their  Report  laid  before  the  House  of 
Commons,  in  the  last  session  of  Parliament ;  in  conse 
quence  of  which  the  sum  of  twenty  thousand  pounds 
was  voted  to  Dr.  Jenner,  as  a  remuneration  for  his 
discovery,  in  addition  to  ten  thousand  pounds  before 
granted."  (In  June,  1802.) 

These  and  similar  accusations,  so  often  brought  up 
against  the  Medical  Profession,  are  only  one  mode  in 
which  is  manifested  a  spirit  of  opposition  not  merely 
to  medical  science,  but  to  all  science,  and  to  all  sound 
knowledge.  It  is  a  spirit  which  neither  understands 
itself  nor  the  object  at  which  it  is  aiming.  It  gropes 
among  the  loose  records  of  the  past,  and  the  floating 
fables  of  the  moment,  to  glean  a  few  truths  or  false 
hoods  tending  to  prove,  if  they  prove  anything,  that 
the  persons  who  have  passed  their  lives  in  the  study 
of  a  branch  of  knowledge  the  very  essence  of  which 
must  always  consist  in  long  and  accurate  observation, 
are  less  competent  to  judge  of  new  doctrines  in  their 
own  department  than  the  rest  of  the  community.  It 
belongs  to  the  clown  in  society,  the  destructive  in  pol 
itics,  and  the  rogue  in  practice. 

The  name  of  Harvey,  whose  great  discovery  was  the 
legitimate  result  of  his  severe  training  and  patient 
study,  should  be  mentioned  only  to  check  the  preten 
sions  of  presumptuous  ignorance.  The  example  of 
Jenner,  who  gave  his  inestimable  secret,  the  result  of 
twenty-two  years  of  experiment  and  researches,  un- 
purchased,  to  the  public,  —  when,  as  was  said  in  Par 
liament,  he  might  have  made  a  hundred  thousand 


98  MEDICAL  ESSAYS. 

pounds  by  it  as  well  as  any  smaller  sum,  —  should  be 
referred  to  only  to  rebuke  the  selfish  venders  of  secret 
remedies,  among  whom  his  early  history  obliges  us  re 
luctantly  to  record  Samuel  Hahnemann.  Those  who 
speak  of  the  great  body  of  physicians  as  if  they  were 
united  in  a  league  to  support  the  superannuated  no 
tions  of  the  past  against  the  progress  of  improvement, 
have  read  the  history  of  medicine  to  little  purpose. 
The  prevalent  failing  of  this  profession  has  been,  on 
the  contrary,  to  lend  a  too  credulous  ear  to  ambitious 
and  plausible  innovators.  If  at  the  present  time  ten 
years  of  public  notoriety  have  passed  over  any  doctrine 
professing  to  be  of  importance  in  medical  science,  and 
if  it  has  not  succeeded  in  raising  up  a  powerful  body 
of  able,  learned,  and  ingenious  advocates  for  its  claims, 
the  fault  must  be  in  the  doctrine  and  not  in  the  medi 
cal  profession. 

Homoaopathy  has  had  a  still  more  extended  period 
of  trial  than  this,  and  we  have  seen  with  what  results. 
It  only  remains  to  throw  out  a  few  conjectures  as  to 
the  particular  manner  in  which  it  is  to  break  up  and 
disappear. 

1.  The  confidence  of  the  few  believers  in  this  delu 
sion  will  never  survive  the  loss  of  friends  who  may 
die  of  any  acute  disease,  under  a  treatment  such  as 
that  prescribed  by  Homosopathy.     It  is  doubtful  how 
far  cases  of  this  kind  will  be  trusted  to  its  tender  mer 
cies,  but  wherever  it  acquires  any  considerable  foot 
hold,  such  cases  must  come,  and  with  them  the  ruin  of 
those  who  practise  it,  should  any  highly  valued  life  be 
thus  sacrificed. 

2.  After  its  novelty  has  worn  out,  the  ardent  and 
capricious  individuals  who  constitute  the  most  promi 
nent  class  of  its  patrons  will  return  to  visible  doses, 
were  it  only  for  the  sake  of  a  change. 


HOMCEOPATHY    AND   ITS   KINDRED   DELUSIONS.     99 

3.  The  Semi-Homoeopathic  practitioner  will  gradu 
ally  withdraw  from  the  rotten  half  of  his  business  and 
try  to  make  the  public  forget  his  connection  with  it. 

4.  The  ultra  Homceopathist  will  either  recant  and 
try  to  rejoin  the  medical  profession ;  or  he  will  em 
brace  some  newer  and  if  possible  equally  extravagant 
doctrine ;  or  he  will  stick  to  his  colors  and  go  down 
with  his  sinking  doctrine.      Very  few  will  pursue  the 
course  last  mentioned. 

A  single  fact  may  serve  to  point  out  in  what  direc 
tion  there  will  probably  be  a  movement  of  the  dissolv 
ing  atoms  of  Homoeopathy.  On  the  13th  page  of  the 
too  frequently  cited  Manifesto  of  the  "  Examiner  "  I 
read  the  following  stately  paragraph :  — 

"  Bigelius,  M.  D.,  physician  to  the  Emperor  of 
Russia,  whose  elevated  reputation  is  well  known  in 
Europe,  has  been  an  acknowledged  advocate  of  Hah- 
nemann's  doctrines  for  several  years.  He  abandoned 
Allopathia  for  Homoeopathia."  The  date  of  this  state 
ment  is  January,  1840.  I  find  on  looking  at  the  book 
sellers'  catalogues  that  one  Bigel,  or  Bigelius,  to  speak 
more  classically,  has  been  at  various  times  publishing 
Homoeopathic  books  for  some  years. 

Again,  on  looking  into  the  "  Encyclographie  des 
Sciences  Me'dicales  "  for  April,  1840,  I  find  a  work 
entitled  "  Manual  of  HYDROSUDOPATHY,  or  the  Treat 
ment  of  Diseases  by  Cold  Water,  etc.,  etc.,  by  Dr.  Bi 
gel,  Physician  of  the  School  of  Strasburg,  Member  of 
the  Medico-Chirurgical  Institute  of  Naples,  of  the 
Academy  of  St.  Petersburg,  —  Assessor  of  the  Col 
lege  of  the  Empire  of  Russia,  Physician  of  his  late 
Imperial  Highness  the  Grand  Duke  Constantino, 
Chevalier  of  the  Legion  of  Honor,  etc."  Hydrosu- 
dopathy  or  Hydropathy,  as  it  is  sometimes  called,  is  a 


100  MEDICAL   ESSAYS. 

new  medical  doctrine  or  practice  which  has  sprung  tip 
in  Germany  since  Homoeopathy,  which  it  bids  fair  to 
drive  out  of  the  market,  if,  as  Dr.  Bigel  says,  fourteen 
physicians  afflicted  with  diseases  which  defied  them 
selves  and  their  colleagues  came  to  Graefenberg,  in 
the  year  1836  alone,  and  were  cured.  Now  Dr.  Bigel, 
"  whose  elevated  reputation  is  well  known  in  Europe," 
writes  as  follows  :  "  The  reader  will  not  fail  to  see  in 
this  defence  of  the  curative  method  of  Graefenberg  a 
profession  of  medical  faith,  and  he  will  be  correct  in 
so  doing."  And  his  work  closes  with  the  following 
sentence,  worthy  of  so  distinguished  an  individual: 
"  We  believe,  with  religion,  that  the  water  of  baptism 
purifies  the  soul  from  its  original  sin ;  let  us  believe 
also,  with  experience,  that  it  is  for  our  corporeal  sins 
the  redeemer  of  the  human  body."  If  Bigel,  Physi 
cian  to  the  late  Grand  Duke  Constantine,  is  identical 
with  Bigel  whom  the  "  Examiner  "  calls  Physician  to 
the  Emperor  of  Russia,  it  appears  that  he  is  now  ac 
tively  engaged  in  throwing  cold  water  at  once  upon  his 
patients  and  the  future  prospects  of  Homoeopathy. 

If,  as  must  be  admitted,  no  one  of  Hahnemann's 
doctrines  is  received  with  tolerable  unanimity  among 
his  disciples,  except  the  central  axiom,  Similia  simil- 
ibus  curantur  ;  if  this  axiom  itself  relies  mainly  for 
its  support  upon  the  folly  and  trickery  of  Hahnemann, 
what  can  we  think  of  those  who  announce  themselves 
ready  to  relinquish  all  the  accumulated  treasures  of 
our  art,  to  trifle  with  life  upon  the  strength  of  these 
fantastic  theories  ?  What  shall  we  think  of  professed 
practitioners  of  medicine,  if,  in  the  words  of  Jahr, 
'•'  from  ignorance,  for  their  personal  convenience,  or 
through  charlatanism,  they  treat  their  patients  one 


HOMCEOPATHY   AND   ITS   KINDRED   DELUSIONS.    101 

day  Homoeopathically  and  the  next  Allopathically ;  " 
if  they  parade  their  pretended  new  science  before  the 
unguarded  portion  of  the  community ;  if  they  suffer 
their  names  to  be  coupled  with  it  wherever  it  may 
gain  a  credulous  patient ;  and  deny  all  responsibility 
for  its  character,  refuse  all  argument  for  its  doctrines, 
allege  no  palliation  for  the  ignorance  and  deception 
interwoven  with  every  thread  of  its  flimsy  tissue,  when 
they  are  questioned  by  those  competent  to  judge  and 
entitled  to  an  answer  ? 

Such  is  the  pretended  science  of  Homosopathy,  to 
which  you  are  asked  to  trust  your  lives  and  the  lives 
of  those  dearest  to  you.  A  mingled  mass  of  perverse 
ingenuity,  of  tinsel  erudition,  of  imbecile  credulity, 
and  of  artful  misrepresentation,  too  often  mingled  in 
practice,  if  we  may  trust  the  authority  of  its  founder, 
with  heartless  and  shameless  imposition.  Because  it 
is  suffered  so  often  to  appeal  unanswered  to  the  pub 
lic,  because  it  has  its  journals,  its  patrons,  its  apostles, 
some  are  weak  enough  to  suppose  it  can  escape  the 
inevitable  doom  of  utter  disgrace  and  oblivion.  Not 
many  years  can  pass  away  before  the  same  curiosity 
excited  by  one  of  Perkins's  Tractors  will  be  awakened 
at  the  sight  of  one  of  the  Infinitesimal  Globules.  If 
it  should  claim  a  longer  existence,  it  can  only  be  by 
falling  into  the  hands  of  the  sordid  wretches  who  wring 
their  bread  from  the  cold  grasp  of  disease  and  death 
in  the  hovels  of  ignorant  poverty. 

As  one  humble  member  of  a  profession  which  for 
more  than  two  thousand  years  has  devoted  itself  to 
the  pursuit  of  the  best  earthly  interests  of  mankind, 
always  assailed  and  insulted  from  without  by  such  as 
are  ignorant  of  its  infinite  perplexities  and  labors, 
always  striving  in  unequal  contest  with  the  hundred- 


102 


MEDICAL   ESSAYS. 


armed  giant  who  walks  in  the  noonday,  and  sleeps  not 
in  the  midnight,  yet  still  toiling,  not  merely  for  itself 
and  the  present  moment,  but  for  the  race  and  the  fu 
ture,  I  have  lifted  my  voice  against  this  lifeless  delu 
sion,  rolling  its  shapeless  bulk  into  the  path  of  a  noble 
science  it  is  too  weak  to  strike,  or  to  injure. 


II, 

THE  CONTAGIOUSNESS  OF  PUERPERAL  FEVER.- 


THE  POINT  AT  ISSUE. 


THE  AFFIRMATIVE. 

"  The  disease  known  as  Puerperal  Fever  is  so  far  contagious  as  to  be 
frequently  carried  from  patient  to  patient  by  physicians  and  nurses."  — 
0.  W.  Holmet,  1843. 

THE  NEGATIVE. 

"The  result  of  the  whole  discussion  will,  I  trust,  serve,  not  only  to  exalt 
your  views  of  the  value  and  dignity  of  our  profession,  but  to  divest  your 
minds  of  the  overpowering  dread  that  you  can  ever  become,  especially  to 
woman,  under  the  extremely  interesting  circumstances  of  gestation  and 
parturition,  the  minister  of  evil  ;  that  you  can  ever  convey,  in  any  possi 
ble  manner,  a  horrible  virus,  so  destructive  in  its  effects,  and  so  mysterious 
in  its  operations  as  that  attributed  to  puerperal  fever."  —  Professor  Hodge, 
1852. 

"  I  prefer  to  attribute  them  to  accident,  or  Providence,  of  which  I  can 
form  a  conception,  rather  than  to  a  contagion  of  which  I  cannot  form  any 
clear  idea,  at  least  as  to  this  particular  malady."  — Professor  Meigs,  1852. 

"...  in  the  propagation  of  which  they  have  no  more  to  do,  than 
with  the  propagation  of  cholera  from  Jessore  to  San  Francisco,  and  from 
Mauritius  to  St.  Petersburg."  —  Professor  Meigs,  1854. 


"  I  arrived  at  that  certainty  in  the  matter,  that  I  could  venture  to  fore 
tell  what  women  would  be  affected  with  the  disease,  upon  hearing  by  what 
midwife  they  were  to  be  delivered,  or  by  what  nurse  they  were  to  be  at 
tended,  during  their  lying-in  ;  and,  almost  in  every  instance,  my  predic 
tion  was  verified."  —  Gordon,  1795. 

a  Printed  in  1843;  reprinted  with  additions,  1856. 


104  MEDICAL  ESSAYS. 

"  A  certain  number  of  deaths  is  caused  every  year  by  the  contagion  of 
puerperal  fever,  communicated  by  the  nurses  and  medical  attendants."  — 
Farr,  in  Fifth  Annual  Report  of  Registrar-General  of  England,  1843. 

"...  boards  of  health,  if  such  exist,  or,  without  them,  the  medical  in- 
Btitutions  of  a  country,  should  have  the  power  of  coercing,  or  of  inflicting 
some  kind  of  punishment  on  those  who  recklessly  go  from  cases  of  puer 
peral  fevers  to  parturient  or  puerperal  females,  without  using  due  precau 
tion  ;  and  who,  having  been  shown  the  risk,  criminally  encounter  it,  and 
convey  pestilence  and  death  to  the  persons  they  are  employed  to  aid  in  the 
most  interesting  and  suffering  period  of  female  existence."  —  Copland's 
Medical  Dictionary,  Art.  Puerperal  States  and  Diseases,  1852. 

"  We  conceive  it  unnecessary  to  go  into  detail  to  prove  the  contagious 
nature  of  this  disease,  as  there  are  few,  if  any,  American  practitioners  who 
do  not  believe  in  this  doctrine."  —Dr.  Lee,  in  Additions  to  Article  last 
cited. 


[INTRODUCTORY  NOTE.]  It  happened,  some  years 
ago,  that  a  discussion  arose  in  a  Medical  Society  of 
which  I  was  a  member,  involving  the  subject  of  a  cer 
tain  supposed  cause  of  disease,  about  which  something 
was  known,  a  good  deal  suspected,  and  not  a  little 
feared.  The  discussion  was  suggested  by  a  case,  re 
ported  at  the  preceding  meeting,  of  a  physician  who 
made  an  examination  of  the  body  of  a  patient  who  had 
died  with  puerperal  fever,  and  who  himself  died  in 
less  than  a  week,  apparently  in  consequence  of  a 
wound  received  at  the  examination,  having  attended 
several  women  in  confinement  in  the  mean  time,  all  of 
whom,  as  it  was  alleged,  were  attacked  with  puerperal 
fever. 

Whatever  apprehensions  and  beliefs  were  enter 
tained,  it  was  plain  that  a  fuller  knowledge  of  the 
facts  relating  to  the  subject  would  be  acceptable  to  all 
present.  I  therefore  felt  that  it  would  be  doing  a 
good  service  to  look  into  the  best  records  I  could  find, 
and  inquire  of  the  most  trustworthy  practitioners  I 


THE  CONTAGIOUSNESS  OF  PUERPERAL  FEVER.  105 

knew,  to  learn  what  experience  had  to  teach  in  the 
matter,  and  arrived  at  the  results  contained  in  the 
following  pages. 

The  Essay  was  read  before  the  Boston  Society  for 
Medical  Improvement,  and,  at  the  request  of  the  So 
ciety,  printed  in  the  "  New  England  Quarterly  Jour 
nal  of  Medicine  and  Surgery  "  for  April,  1843.  As 
this  Journal  never  obtained  a  large  circulation,  and 
ceased  to  be  published  after  a  year's  existence,  and 
as  the  few  copies  I  had  struck  off  separately  were 
soon  lost  sight  of  among  the  friends  to  whom  they 
were  sent,  the  Essay  can  hardly  be  said  to  have  been 
fully  brought  before  the  Profession. 

The  subject  of  this  Paper  has  the  same  profound 
interest  for  me  at  the  present  moment  as  it  had  when 
I  was  first  collecting  the  terrible  evidence  out  of 
which,  as  it  seems  to  me,  the  commonest  exercise  of 
reason  could  not  help  shaping  the  truth  it  involved. 
It  is  not  merely  on  account  of  the  bearing  of  the  ques 
tion,  —  if  there  is  a  question,  —  on  all  that  is  most 
sacred  in  human  life  and  happiness,  that  the  subject 
cannot  lose  its  interest.  It  is  because  it  seems  evident 
that  a  fair  statement  of  the  facts  must  produce  its 
proper  influence  on  a  very  large  proportion  of  well- 
constituted  and  unprejudiced  minds.  Individuals  may, 
here  and  there,  resist  the  practical  bearing  of  the  evi 
dence  on  their  own  feelings  or  interests ;  some  may 
fail  to  see  its  meaning,  as  some  persons  may  be  found 
who  cannot  tell  red  from  green  ;  but  I  cannot  doubt 
that  most  readers  will  be  satisfied  and  convinced,  to 
loathing,  long  before  they  have  finished  the  dark  obit 
uary  calendar  laid  before  them. 

I  do  not  know  that  I  shall  ever  again  have  so  good 
an  opportunity  of  being  useful  as  was  granted  me  by 


106  MEDICAL  ESSAYS. 

the  raising  of  the  question  which  produced  this  Essay. 
For  I  have  abundant  evidence  that  it  has  made  many 
practitioners  more  cautious  in  their  relations  with 
puerperal  females,  and  I  have  no  doubt  it  will  do  so 
still,  if  it  has  a  chance  of  being  read,  though  it  should 
call  out  a  hundred  counterblasts,  proving  to  the  satis 
faction  of  their  authors  that  it  proved  nothing.  And 
for  my  part,  I  had  rather  rescue  one  mother  from  be 
ing  poisoned  by  her  attendant,  than  claim  to  have 
saved  forty  out  of  fifty  patients  to  whom  I  had  car 
ried  the  disease.  Thus,  I  am  willing  to  avail  myself  of 
any  hint  coming  from  without  to  offer  this  paper  once 
more  to  the  press.  The  occasion  has  presented  itself,  as 
will  be  seen,  in  a  convenient  if  not  in  a  flattering  form. 

I  send  this  Essay  again  to  the  MEDICAL  PROFES 
SION,  without  the  change  of  a  word  or  syllable.  I 
find,  on  reviewing  it,  that  it  anticipates  and  eliminates 
those  secondary  questions  which  cannot  be  entertained 
for  a  moment  until  the  one  great  point  of  fact  is  per 
emptorily  settled.  In  its  very  statement  of  the  doc 
trine  maintained  it  avoids  all  discussion  of  the  nature 
of  the  disease  "  known  as  puerperal  fever,"  and  all 
the  somewhat  stale  philology  of  the  word  contagion. 
It  mentions,  fairly  enough,  the  names  of  sceptics,  or 
unbelievers  as  to  the  reality  of  personal  transmission  ; 
of  Dewees,  of  Tonnelle",  of  Duges,  of  Baudelocque, 
and  others ;  of  course,  not  including  those  whose 
works  were  then  unwritten  or  unpublished ;  nor  enu 
merating  all  the  Continental  writers  who,  in  ignorance 
of  the  great  mass  of  evidence  accumulated  by  British 
practitioners,  could  hardly  be  called  well  informed  on 
this  subject.  It  meets  all  the  array  of  negative  cases, 
—  those  in  which  disease  did  not  follow  exposure,  — 


THE  CONTAGIOUSNESS  OF  PUERPERAL  FEVER.  107 

by  the  striking  example  of  small-pox,  which,  although 
one  of  the  most  contagious  of  diseases,  is  subject  to 
the  most  remarkable  irregularities  and  seeming  ca 
prices  in  its  transmission.  It  makes  full  allowance  for 
other  causes  besides  personal  transmission,  especially 
for  epidemic  influences.  It  allows  for  the  possibility 
of  different  modes  of  conveyance  of  the  destructive 
principle.  It  recognizes  and  supports  the  belief  that 
a  series  of  cases  may  originate  from  a  single  primitive 
source  which  affects  each  new  patient  in  turn  ;  and  es 
pecially  from  cases  of  Erysipelas.  It  does  not  under 
take  to  discuss  the  theoretical  aspect  of  the  subject ; 
that  is  a  secondary  matter  of  consideration.  Where 
facts  are  numerous,  and  unquestionable,  and  unequiv 
ocal  in  their  significance,  theory  must  follow  them  as 
it  best  may,  keeping  time  with  their  step,  and  not  go 
before  them,  marching  to  the  sound  of  its  own  drum 
and  trumpet.  Having  thus  narrowed  its  area  to  a  lim 
ited  practical  platform  of  discussion,  a  matter  of  life 
and  death,  and  not  of  phrases  or  theories,  it  covers 
every  inch  of  it  with  a  mass  of  evidence  which  I  con 
ceive  a  Committee  of  Husbands,  who  can  count  coinci 
dences  and  draw  conclusions  as  well  as  a  Synod  of 
Accoucheurs,  would  justly  consider  as  affording  ample 
reasons  for  an  unceremonious  dismissal  of  a  practi 
tioner  (if  it  is  conceivable  that  such  a  step  could  be 
waited  for),  after  five  or  six  funerals  had  marked  the 
path  of  his  daily  visits,  while  other  practitioners  were 
not  thus  escorted.  To  the  Profession,  therefore,  I 
submit  the  paper  in  its  original  form,  and  leave  it  to 
take  care  of  itself. 

To  the  MEDICAX,  STUDENTS,  into  whose  hands  this 
Essay  may  fall,  some  words  of  introduction  may  be 


108  MEDICAL  ESSAYS. 

appropriate,  and  perhaps,  to  a  small  number  of  them, 
necessary.  There  are  some  among  them  who,  from 
youth,  or  want  of  training,  are  easily  bewildered  and 
confused  in  any  conflict  of  opinions  into  which  their 
studies  lead  them.  They  are  liable  to  lose  sight  of 
the  main  question  in  collateral  issues,  and  to  be  run 
away  with  by  suggestive  speculations.  They  confound 
belief  with  evidence,  often  trusting  the  first  because  it 
is  expressed  with  energy,  and  slighting  the  latter  be 
cause  it  is  calm  and  unimpassioned.  They  are  not 
satisfied  with  proof ;  they  cannot  believe  a  point  is 
settled  so  long  as  everybody  is  not  silenced.  They 
have  not  learned  that  error  is  got  out  of  the  minds 
that  cherish  it,  as  the  taenia  is  removed  from  the  body, 
one  joint,  or  a  few  joints  at  a  time,  for  the  most  part, 
rarely  the  whole  evil  at  once.  They  naturally  have 
faith  in  their  instructors,  turning  to  them  for  truth, 
and  taking  what  they  may  choose  to  give  them ;  babes 
in  knowledge,  not  yet  able  to  tell  the  breast  from  the 
bottle,  pumping  away  for  the  milk  of  truth  at  all  that 
offers,  were  it  nothing  better  than  a  Professor's  shriv 
elled  forefinger. 

In  the  earliest  and  embryonic  stage  of  professional 
development,  any  violent  impression  on  the  instruct 
or's  mind  is  apt  to  be  followed  by  some  lasting  effect 
on  that  of  the  pupil.  No  mother's  mark  is  more  per 
manent  than  the  mental  nsevi  and  moles,  and  excres 
cences,  and  mutilations,  that  students  carry  with  them 
out  of  the  lecture-room,  if  once  the  teeming  intellect 
which  nourishes  theirs  has  been  scared  from  its  pro 
priety  by  any  misshapen  fantasy.  Even  an  impatient 
or  petulant  expression,  which  to  a  philosopher  would 
be  a  mere  index  of  the  low  state  of  amiability  of  the 
speaker  at  the  moment  of  its  utterance,  may  pass  into 


THE  CONTAGIOUSNESS  OP  PUERPERAL  FEVER.  109 

the  young  mind  as  an  element  of  its  future  constitu 
tion,  to  injure  its  temper  or  corrupt  its  judgment.  It 
is  a  duty,  therefore,  which  we  owe  to  this  younger 
class  of  students,  to  clear  any  important  truth  which 
may  have  been  rendered  questionable  in  their  minds 
by  such  language,  or  any  truth-teller  against  whom 
they  may  have  been  prejudiced  by  hasty  epithets,  from 
the  impressions  such  words  have  left.  Until  this  is 
done,  they  are  not  ready  for  the  question,  where  there 
is  a  question,  for  them  to  decide.  Even  if  we  ourselves 
are  the  subjects  of  the  prejudice,  there  seems  to  be 
no  impropriety  in  showing  that  this  prejudice  is  local 
or  personal,  and  not  an  acknowledged  conviction  with 
the  public  at  large.  It  may  be  necessary  to  break 
through  our  usual  habits  of  reserve  to  do  this,  but 
this  is  the  fault  of  the  position  in  which  others  have 
placed  us. 

Two  widely-known  and  highly-esteemed  practition 
ers,  Professors  in  two  of  the  largest  Medical  Schools 
of  the  Union,  teaching  the  branch  of  art  which  in 
cludes  the  Diseases  of  Women,  and  therefore  speak 
ing  with  authority;  addressing  in  their  lectures  and 
printed  publications  large  numbers  of  young  men, 
many  of  them  in  the  tenderest  immaturity  of  knowl 
edge,  have  recently  taken  ground  in  a  formal  way 
against  the  doctrine  maintained  in  this  paper.0  The 

•  On  the  Non- Contagious  Character  of  Puerperal  Fever :  An 
Introductory  Lecture.  By  Hugh  L.  Hodge,  M.  D.,  Professor 
of  Obstetrics  in  the  University  of  Pennsylvania.  Delivered 
Monday,  October  11,  1852.  Philadelphia,  1852. 

On  the  Nature,  Signs,  and  Treatment  of  Childbed  Fevers :  in 
a  Series  of  Letters  addressed  to  the  Students  of  his  Class.  By 
Charles  D.  Meigs,  M.  D.,  Professor  of  Midwifery  and  the  Dis 
eases  of  Women  and  Children  in  Jefferson  Medical  College, 
Philadelphia,  etc.,  etc.  Philadelphia,  1854.  Letter  VI. 


110  MEDICAL   ESSAYS. 

first  of  the  two  publications,  Dr.  Hodge's  Lecture, 
while  its  theoretical  considerations  and  negative  ex 
periences  do  not  seem  to  me  to  require  any  further 
notice  than  such  as  lay  ready  for  them  in  my  Essay 
written  long  before,  is,  I  am  pleased  to  say,  unobjec 
tionable  in  tone  and  language,  and  may  be  read  with 
out  offence. 

This  can  hardly  be  said  of  the  chapter  of  Dr. 
Meigs's  volume  which  treats  of  Contagion  in  Childbed 
Fever.  There  are  expressions  used  in  it  which  might 
well  put  a  stop  to  all  scientific  discussions,  were  they 
to  form  the  current  coin  in  our  exchange  of  opinions. 
I  leave  the  "very  young  gentlemen,"  whose  careful 
expositions  of  the  results  of  practice  in  more  than  six 
thousand  cases  are  characterized  as  "  the  jejune  and 
fizenless  dreamings  of  sophomore  writers,"  to  the  sym 
pathies  of  those  "  dear  young  friends,"  and  "  dear 
young  gentlemen,"  who  will  judge  how  much  to  value 
their  instructor's  counsel  to  think  for  themselves,  know 
ing  what  they  are  to  expect  if  they  happen  not  to 
think  as  he  does. 

One  unpalatable  expression  I  suppose  the  laws  of 
construction  oblige  me  to  appropriate  to  myself,  as 
my  reward  for  a  certain  amount  of  labor  bestowed  on 
the  investigation  of  a  very  important  question  of  evi 
dence,  and  a  statement  of  my  own  practical  conclu 
sions.  I  take  no  offence,  and  attempt  no  retort.  No 
man  makes  a  quarrel  with  me  over  the  counterpane 
that  covers  a  mother,  with  her  new-born  infant  at  her 
breast.  There  is  no  epithet  in  the  vocabulary  of  slight 
and  sarcasm  that  can  reach  my  personal  sensibilities  in 
such  a  controversy.  Only  just  so  far  as  a  disrespect 
ful  phrase  may  turn  the  student  aside  from  the  exami 
nation  of  the  evidence,  by  discrediting  or  dishonoring 
the  witness,  does  it  call  for  any  word  of  notice. 


THE  CONTAGIOUSNESS  OF  PUERPERAL  FEVER.  Ill 

I  appeal  from  the  disparaging  language  by  which 
the  Professor  in  the  Jefferson  School  of  Philadelphia 
would  dispose  of  my  claims  to  be  listened  to.  I  appeal, 
not  to  the  vote  of  the  Society  for  Medical  Improve 
ment,  although  this  was  an  unusual  evidence  of  inter 
est  in  the  paper  in  question,  for  it  was  a  vote  passed 
among  my  own  townsmen  ;  nor  to  the  opinion  of  any 
American,  for  none  know  better  than  the  Professors 
in  the  great  Schools  of  Philadelphia  how  cheaply  the 
praise  of  native  contemporary  criticism  is  obtained. 
I  appeal  to  the  recorded  opinions  of  those  whom  I  do 
not  know,  and  who  do  not  know  me,  nor  care  for  me, 
except  for  the  truth  that  I  may  have  uttered ;  to  Cop 
land,  in  his  "  Medical  Dictionary,"  who  has  spoken 
of  my  Essay  in  phrases  to  which  the  pamphlets  of 
American  "  scribblers "  are  seldom  used  from  Euro 
pean  authorities ;  to  Ramsbotham,  whose  compendious 
eulogy  is  all  that  self-love  could  ask ;  to  the  "  Fifth 
Annual  Report "  of  the  Registrar-General  of  Eng 
land,  in  which  the  second-hand  abstract  of  my  Essay 
figures  largely,  and  not  without  favorable  comment, 
in  an  important  appended  paper.  These  testimonies, 
half  forgotten  until  this  circumstance  recalled  them, 
are  dragged  into  the  light,  not  in  a  paroxysm  of  vanity, 
but  to  show  that  there  may  be  food  for  thought  in  the 
small  pamphlet  which  the  Philadelphia  Teacher  treats 
so  lightly.  They  were  at  least  unsought  for,  and 
would  never  have  been  proclaimed  but  for  the  sake  of 
securing  the  privilege  of  a  decent  and  unprejudiced 
hearing. 

I  will  take  it  for  granted  that  they  have  so  far 
counterpoised  the  depreciating  language  of  my  fellow- 
countryman  and  fellow-teacher  as  to  gain  me  a  reader 
here  and  there  among  tie  youthful  class  of  students 


112  MEDICAL   ESSAYS. 

I  am  now  addressing.  It  is  only  for  their  sake  that  I 
think  it  necessary  to  analyze,  or  explain,  or  illustrate, 
or  corroborate  any  portion  of  the  following  Essay. 
But  I  know  that  nothing  can  be  made  too  plain  for 
beginners ;  and  as  I  do  not  expect  the  practitioner,  or 
even  the  more  mature  student,  to  take  the  trouble  to 
follow  me  through  an  Introduction  which  I  consider 
wholly  unnecessary  and  superfluous  for  them,  I  shall 
not  hesitate  to  stoop  to  the  most  elementary  simplicity 
for  the  benefit  of  the  younger  student.  I  do  this  more 
willingly  because  it  affords  a  good  opportunity,  as  it 
seems  to  me,  of  exercising  the  untrained  mind  in  that 
medical  logic  which  does  not  seem  to  have  been  either 
taught  or  practised  in  our  schools  of  late,  to  the  ex 
tent  that  might  be  desired. 

I  will  now  exhibit,  in  a  series  of  propositions  re 
duced  to  their  simplest  expression,  the  same  essential 
statements  and  conclusions  as  are  contained  in  the 
Essay,  with  such  commentaries  and  explanations  as 
may  be  profitable  to  the  inexperienced  class  of  readers 
addressed. 

I.  It  has  been  long  believed,  by  many  competent 
observers,  that  Puerperal  Fever  (so  called)  is  some 
times  carried  from  patient  to  patient  by  medical  as 
sistants. 

II.  The  express  object  of  this  Essay  is  to  prove  that 
it  is  so  carried. 

III.  In  order  to  prove  this  point,  it  is  not  necessary 
to  consult  any  medical  theorist  as  to  whether  or  not 
it  is  consistent  with  his  preconceived  notions  that  such 
a  mode  of  transfer  should  exist. 

IV.  If  the  medical   theorist  insists  on   being  con 
sulted,  and  we  see  fit  to  indulge  him,  he  cannot  be  al 


THE  CONTAGIOUSNESS  OF  PUERPERAL  FEVER.  118 

lowed  to  assume  that  the  alleged  laws  of  contagion, 
deduced  from  observation  in  other  diseases,  shall  be 
cited  to  disprove  the  alleged  laws  deduced  from  ob 
servation  in  this.  Science  would  never  make  progress 
under  such  conditions.  Neither  the  long  incubation 
of  hydrophobia,  nor  the  protecting  power  of  vaccina 
tion,  would  ever  have  been  admitted,  if  the  results  of 
observation  in  these  affections  had  been  rejected  as 
contradictory  to  the  previously  ascertained  laws  of 
contagion. 

V.  The  disease  in  question  is  not  a  common  one ; 
producing,  on  the  average,  about  three   deaths  in  a 
thousand  births,  according  to  the  English  Registration 
returns  which  I  have  examined. 

VI.  When  an  unusually  large  number  of  cases  of 
this  disease  occur  about  the  same  time,  it  is  inferred, 
therefore,  that  there  exists  some  special  cause  for  this 
increased  frequency.     If  the  disease   prevails  exten 
sively  over  a  wide  region  of  country,  it  is  attributed 
without  dispute  to  an  epidemic  influence.     If  it  pre 
vails  in  a  single  locality,  as  in  a  hospital,  and  not  else 
where,  this  is  considered  proof  that  some  local  cause 
is  there  active  in  its  production. 

VII.  When  a  large  number  of  cases  of  this  disease 
occur  in  rapid  succession,  in  one  individual's  ordinary 
practice,  and  few  or  none  elsewhere,  these  cases  ap 
pearing  in  scattered  localities,  in  patients  of  the  same 
average  condition  as  those  who  escape  under  the  care 
of  others,  there  is  the  same  reason  for  connecting  the 
cause  of  the  disease  with  the  person  in  this  instance, 
as  with  the  place  in  that  last  mentioned. 

VIII.  Many  series  of  cases,  answering  to  these  con 
ditions,  are  given  in  this  Essay,  and  many  others  will 


114  MEDICAL   ESSAYS. 

be  referred  to  which  have  occurred  since  it  was  writ 
ten. 

IX.  The  alleged  results  of  observation  may  be  set 
aside ;  first,  because  the  so-called  facts  are  in  their 
own  nature  equivocal;   secondly,  because  they  stand 
on  insufficient  authority ;  thirdly,  because  they  are  not 
sufficiently  numerous.     But,  in  this  case,  the  disease 
is  one  of  striking  and  well-marked  character  ;  the  wit 
nesses  are   experts,  interested  in  denying  and  disbe 
lieving  the  facts ;  the  number  of  consecutive  cases  in 
many  instances  frightful,  and  the  number  of  series  of 
cases  such  that  I  have  no  room  for  many  of  them  ex 
cept  by  mere  reference. 

X.  These  results  of  observation,  being  admitted, 
may,  we  will  suppose,  be  interpreted  in  different  meth 
ods.     Thus   the   coincidences  may  be  considered  the 
effect  of  chance.     I  have  had  the  chances  calculated 
by  a  competent  person,  that  a  given  practitioner,  A., 
shall  have  sixteen  fatal  cases  in  a  month,  on  the  fol 
lowing  data  :  A.  to  average  attendance  upon  two  hun 
dred  and  fifty  births  in  a  year ;  three  deaths  in  one 
thousand  births  to  be  assumed  as  the  average  from 
puerperal  fever ;  no  epidemic  to  be  at  the  time  pre 
vailing.     It  follows,  from  the  answer  given  me,  that  if 
we  suppose  every  one  of  the  five  hundred  thousand 
annual  births  of  England  to  have  been  recorded  dur 
ing  the   last   half-century,  there   would  not  be   one 
chance  in  a  million  million  million  millions  that  one 
such  series  should  be  noted.     No  possible  fractional 
error  in  this  calculation  can  render  the  chance  a  work 
ing  probability.     Applied  to  dozens  of  series  of  vari 
ous   lengths,  it  is   obviously  an   absurdity.     Chance, 
therefore,  is  out  of  the  question  as  an  explanation  of 
the  admitted  coincidences. 


THE   CONTAGIOUSNESS   OF  PUERPEKAL   FEVER.    115 

XI.  There  is,  therefore,  some  relation  of  cause  and 
effect  between  the  physician's  presence  and  the  pa 
tient's  disease. 

XII.  Until  it  is  proved  to  what  removable  condi 
tion  attaching  to  the  attendant  the  disease  is  owing, 
he  is  bound  to  stay  away  from  his  patients  so  soon  as 
he  finds  himself  singled  out  to  be  tracked  by  the  dis 
ease.    How  long,  and  with  what  other  precautions,  I 
have  suggested,  without  dictating,  at  the  close  of  my 
Essay.     If  the  physician  does  not  at  once  act  on  any 
reasonable  suspicion  of  his  being  the  medium  of  trans 
fer,  the  families  where  he  is  engaged,  if  they  are  al 
lowed  to  know  the  facts,  should  decline  his  services  for 
the  time.     His  feelings  on  the  occasion,  however  in 
teresting  to  himself,  should  not  be  even  named  in  this 
connection.     A  physician  who  talks  about  ceremony 
and  gratitude,  and  services  rendered,  and  the  treat 
ment  he  got,  surely  forgets  himself ;  it  is  impossible 
that  he  should  seriously  think  of  these  small  matters 
where  there  is  even  a  question  whether  he  may  not 
carry  disease,  and  death,  and  bereavement  into  any 
one  of  "  his  families,"  as  they  are  sometimes  called. 

I  will  now  point  out  to  the  young  student  the  mode 
in  which  he  may  relieve  his  mind  of  any  confusion,  or 
possibly,  if  very  young,  any  doubt,  which  the  perusal  of 
Dr.  Meigs's  Sixth  Letter  may  have  raised  in  his  mind. 

The  most  prominent  ideas  of  the  Letter  are,  first, 
that  the  transmissible  nature  of  puerperal  fever  ap 
pears  improbable,  and,  secondly,  that  it  would  be  very 
inconvenient  to  the  writer.  Dr.  Woodville,  Physician 
to  the  Small-Pox  and  Inoculation  Hospital  in  London, 
found  it  improbable,  and  exceedingly  inconvenient  to 
himself,  that  cow-pox  should  prevent  small-pox ;  but 


116  MEDICAL  ESSAYS. 

Dr.  Jenner  took  the  liberty  to  prove  the  fact,  notwith 
standing. 

I  will  first  call  the  young  student's  attention  to  the 
show  of  negative  facts  (exposure  without  subsequent 
disease),  of  which  much  seems  to  be  thought.  And  1 
may  at  the  same  time  refer  him  to  Dr.  Hodge's  Lec 
ture,  where  he  will  find  the  same  kind  of  facts  and 
reasoning.  Let  him  now  take  up  Watson's  Lectures, 
the  good  sense  and  spirit  of  which  have  made  his  book 
a  universal  favorite,  and  open  to  the  chapter  on  Con 
tinued  Fever.  He  will  find  a  paragraph  containing 
the  following  sentence :  "  A  man  might  say,  '  I  was  in 
the  battle  of  Waterloo,  and  saw  many  men  around  me 
fall  down  and  die,  and  it  was  said  that  they  were  struck 
down  by  musket-balls ;  but  I  know  better  than  that,  for 
I  was  there  all  the  time,  and  so  were  many  of  my 
friends,  and  we  were  never  hit  by  any  musket-balls. 
Musket-balls,  therefore,  could  not  have  been  the  cause 
of  the  deaths  we  witnessed.'  And  if,  like  contagion, 
they  were  not  palpable  to  the  senses,  such  a  person 
might  go  on  to  affirm  that  no  proof  existed  of  there 
being  any  such  thing  as  musket-balls."  Now  let  the 
student  turn  back  to  the  chapter  on  Hydrophobia  in 
the  same  volume.  He  will  find  that  John  Hunter  knew 
a  case  in  which,  of  twenty-one  persons  bitten,  only  one 
died  of  the  disease.  He  will  find  that  one  dog  at 
Charenton  was  bitten  at  different  times  by  thirty  dif 
ferent  mad  dogs,  and  outlived  it  all.  Is  there  no  such 
thing,  then,  as  hydrophobia?  Would  one  take  no  es 
pecial  precautions  if  his  wife,  about  to  become  a  mother, 
had  been  bitten  by  a  rabid  animal,  because  so  many 
escape  ?  Or  let  him  look  at  "  Underwood  on  Diseases 
of  Children," a  and  he  will  find  the  case  of  a  young 
•  Philadelphia,  1842,  p.  244,  note. 


THE  CONTAGIOUSNESS  OF  PUERPERAL  FEVER.  117 

woman  who  was  inoculated  eight  times  in  thirty  days, 
at  the  same  time  attending  several  children  with  small 
pox,  and  yet  was  not  infected.  But  seven  weeks  after 
wards  she  took  the  disease  and  died. 

It  would  seem  as  if  the  force  of  this  argument  could 
hardly  fail  to  be  seen,  if  it  were  granted  that  every 
one  of  these  series  of  cases  were  so  reported  as  to 
prove  that  there  could  have  been  no  transfer  of  dis 
ease.  There  is  not  one  of  them  so  reported,  in  the 
Lecture  or  the  Letter,  as  to  prove  that  the  disease  may 
not  have  been  carried  by  the  practitioner.  I  strongly 
suspect  that  it  was  so  carried  in  some  of  these  cases, 
but  from  the  character  of  the  very  imperfect  evidence 
the  question  can  never  be  settled  without  further  dis 
closures. 

Although  the  Letter  is,  as  I  have  implied,  principally 
taken  up  with  secondary  and  collateral  questions,  and 
might  therefore  be  set  aside  as  in  the  main  irrelevant, 
1  am  willing,  for  the  student's  sake,  to  touch  some  of 
these  questions  briefly,  as  an  illustration  of  its  logical 
character. 

The  first  thing  to  be  done,  as  I  thought  when  I 
wrote  my  Essay,  was  to  throw  out  all  discussions  of  the 
word  contagion,  and  this  I  did  effectually  by  the  care 
ful  wording  of  my  statement  of  the  subject  to  be  dis 
cussed.  My  object  was  not  to  settle  the  etymology  or 
definition  of  a  word,  but  to  show  that  women  had  often 
died  in  childbed,  poisoned  in  some  way  by  their  medi 
cal  attendants.  On  the  other  point,  I,  at  least,  have 
no  controversy  with  anybody,  and  I  think  the  student 
will  do  well  to  avoid  it  in  this  connection.  If  I  must 
define  my  position,  however,  as  well  as  the  term  in 
question,  I  am  contented  with  Worcester's  definition ; 
provided  always  this  avowal  do  not  open  another  side- 


118  MEDICAL  ESSAYS. 

controversy  on  the  merits  of  his  Dictionary,  which 
Dr.  Meigs  has  not  cited,  as  compared  with  Webster's, 
which  he  has. 

I  cannot  see  the  propriety  of  insisting  that  all  the 
laws  of  the  eruptive  fevers  must  necessarily  hold  true 
of  this  peculiar  disease  of  puerperal  women.  If  there 
were  any  such  propriety,  the  laws  of  the  eruptive 
fevers  must  at  least  be  stated  correctly.  It  is  not  true, 
for  instance,  as  Dr.  Meigs  states,  that  contagion  is  "  no 
respecter  of  persons ; "  that  "  it  attacks  all  individuals 
alike."  To  give  one  example:  Dr.  Gregory,  of  the 
Small-Pox  Hospital,  who  ought  to  know,  says  that  per 
sons  pass  through  life  apparently  insensible  to  or  un 
susceptible  of  the  small-pox  virus,  and  that  the  same 
persons  do  not  take  the  vaccine  disease. 

As  to  the  short  time  of  incubation,  of  which  so 
much  is  made,  we  have  no  right  to  decide  beforehand 
whether  it  shall  be  long  or  short,  in  the  cases  we  are 
considering.  A  dissection  wound  may  produce  symp 
toms  of  poisoning  in  six  hours;  the  bite  of  a  rabid 
animal  may  take  as  many  months. 

After  the  student  has  read  the  case  in  Dr.  Meigs's 
136th  paragraph,  and  the  following  one,  hi  which  he 
exclaims  against  the  idea  of  contagion,  because  the 
patient,  delivered  on  the  26th  of  December,  was  at 
tacked  in  twenty-four  hours,  and  died  on  the  third  day, 
let  him  read  what  happened  at  the  "  Black  Assizes  " 
of  1577  and  1750.  In  the  first  case,  six  hundred  per 
sons  sickened  the  same  night  of  the  exposure,  and 
three  hundred  more  in  three  days.*  Of  those  attacked 
in  the  latter  year,  the  exposure  being  on  the  llth 
of  May,  Alderman  Lambert  died  on  the  13th,  Under- 
Sheriff  Cox  on  the  14th,  and  many  of  note  before  the 
•  Elliotson's  Practice,  p.  298. 


THE  CONTAGIOUSNESS  OP  PUEKPEEAL  FEVER.  119 

20th."  But  these  are  old  stories.  Let  the  student 
listen  then  to  Dr.  Gerhard,  whose  reputation  as  a 
cautious  observer  he  may  be  supposed  to  know.  "  The 
nurse  was  shaving  a  man,  who  died  in  a  few  hours 
after  his  entrance ;  he  inhaled  his  breath,  which  had 
a  nauseous  taste,  and  in  an  hour  afterwards  was  taken 
with  nausea,  cephalalgia,  and  singing  of  the  ears. 
From  that  moment  the  attack  began,  and  assumed  a 
severe  character.  The  assistant  was  supporting  an 
other  patient,  who  died  soon  afterwards ;  he  felt  the 
pungent  heat  upon  his  skin,  and  was  taken  immediately 
with  the  symptoms  of  typhus." 6  It  is  by  notes  of 
cases,  rather  than  notes  of  admiration,  that  we  must  be 
guided,  when  we  study  the  Revised  Statutes  of  Nature, 
as  laid  down  from  the  curule  chairs  of  Medicine. 

Let  the  student  read  Dr.  Meigs's  140th  paragraph 
soberly,  and  then  remember,  that  not  only  does  he 
infer,  suspect,  and  surmise,  but  he  actually  asserts 
(page  154),  "  there  was  poison  in  the  house,"  because 
three  out  of  five  patients  admitted  into  a  ward  had 
puerperal  fever  and  died.  Have  I  not  as  much  right 
to  draw  a  positive  inference  from  "  Dr.  A.'s  "  seventy 
exclusive  cases  as  he  from  the  three  cases  in  the  ward 
of  the  Dublin  Hospital  ?  All  practical  medicine,  and 
all  action  in  common  affairs,  is  founded  on  inferences. 
How  does  Dr.  Meigs  know  that  the  patients  he  bled 
in  puerperal  fever  would  not  have  all  got  well  if  he 
had  not  bled  them  ? 

"  You  see  a  man  discharge  a  gun  at  another ;  you 
see  the  flash,  you  hear  the  report,  you  see  the  person 
fall  a  lifeless  corpse  ;  and  you  infer,  from  all  these 
circumstances,  that  there  was  a  ball  discharged  from 

"  Rees's  Cyc.  art.  "  Contagion." 

*  Am.  Jour.  Med.  Sciences,  Feb.  1837,  p.  299. 


120  MEDICAL  ESSAYS. 

the  gun,  which  entered  his  body  and  caused  his  death, 
because  such  is  the  usual  and  natural  cause  of  such 
an  effect.  But  you  did  not  see  the  ball  leave  the  gun, 
pass  through  the  air,  and  enter  the  body  of  the  slain ; 
and  your  testimony  to  the  fact  of  killing  is,  therefore, 
only  inferential,  —  in  other  words,  circumstantial.  It 
is  possible  that  no  ball  was  in  the  gun  ;  and  we  infer 
that  there  was,  only  because  we  cannot  account  for 
death  on  any  other  supposition."  ° 

"  The  question  always  comes  to  this  :  Is  the  cir 
cumstance  of  intercourse  with  the  sick  followed  by  the 
appearance  of  the  disease  in  a  proportion  of  cases  so 
much  greater  than  any  other  circumstance  common 
to  any  portion  of  the  inhabitants  of  the  place  under 
observation,  as  to  make  it  inconceivable  that  the  suc 
cession  of  cases  occurring  in  persons  having  that  inter 
course  should  have  been  the  result  of  chance  ?  If  so, 
the  inference  is  unavoidable,  that  that  intercourse 
must  have  acted  as  a  cause  of  the  disease.  All  obser 
vations  which  do  not  bear  strictly  on  that  point  are 
irrelevant,  and,  in  the  case  of  an  epidemic  first  ap 
pearing  in  a  town  or  district,  a  succession  of  two  cases 
is  sometimes  sufficient  to  furnish  evidence  which,  on 
the  principle  I  have  stated,  is  nearly  irresistible."  * 

Possibly  an  inexperienced  youth  may  be  awe-struck 
by  the  quotation  from  Cuvier.  These  words,  or  their 
equivalent,  are  certainly  to  be  found  in  his  Introduc 
tion.  So  are  the  words  "  top  not  come  down  "  !  to 
be  found  in  the  Bible,  and  they  were  as  much  meant 
for  the  ladies'  head-dresses  as  the  words  of  Cuvier 
were  meant  to  make  clinical  observation  wait  for  a 
permit  from  anybody  to  look  with  its  eyes  and  count 

•  Chief  Justice  Gibson,  in  Am.  Law  Journal,  voL  vi.  p.  123, 
Dr.  Alison. 


THE  CONTAGIOUSNESS  OF  PUEEPERAL  FEVER.  121 

on  its   fingers.      Let  the   inquiring  youth  read  the 
whole  Introduction,  and  he  will  see  what  they  mean. 

I  intend  no  breach  of  courtesy,  but  this  is  a  proper 
place  to  warn  the  student  against  skimming  the  pref 
aces  and  introductions  of  works  for  mottoes  and  em 
bellishments  to  his  thesis.  He  cannot  learn  anatomy 
by  thrusting  an  exploring  needle  into  the  body.  He 
will  be  very  liable  to  misquote  his  author's  meaning 
while  he  is  picking  off  his  outside  sentences.  He  may 
make  as  great  a  blunder  as  that  simple  prince  who 
praised  the  conductor  of  his  orchestra  for  the  piece 
just  before  the  overture  ;  the  musician  was  too  good  a 
courtier  to  tell  him  that  it  was  only  the  tuning  of  the 
instruments. 

To  the  six  propositions  in  the  142d  paragraph,  and 
the  remarks  about  "  specific  "  diseases,  the  answer,  if 
any  is  necessary,  seems  very  simple.  An  inflamma 
tion  of  a  serous  membrane  may  give  rise  to  secretions 
which  act  as  a  poison,  whether  that  be  a  "  specific " 
poison  or  not,  as  Dr.  Horner  has  told  his  young  read 
ers,  and  as  dissectors  know  too  well ;  and  that  poison 
may  produce  its  symptoms  in  a  few  hours  after  the 
system  has  received  it,  as  any  may  see  in  Druitt's 
"  Surgery,"  if  they  care  to  look.  Puerperal  peritonitis 
may  produce  such  a  poison,  and  puerperal  women 
may  be  very  sensible  to  its  influences,  conveyed  by 
contact  or  exhalation.  Whether  this  is  so  or  not, 
facts  alone  can  determine,  and  to  facts  we  have  had 
recourse  to  settle  it. 

The  following  statement  is  made  by  Dr.  Meigs  in 
his  142d  paragraph,  and  developed  more  at  length, 
with  rhetorical  amplifications,  in  the  134th.  "  No  hu 
man  being,  save  a  pregnant  or  parturient  woman,  is 
susceptible  to  the  poison."  This  statement  is  wholly 


122  MEDICAL  ESSAYS. 

incorrect,  as  I  am  sorry  to  have  to  point  out  to  a 
Teacher  in  Dr.  Meigs's  position.  I  do  not  object  to  the 
erudition  which  quotes  Willis  and  Fernelius,  the  last 
of  whom  was  pleasantly  said  to  have  "  preserved  the 
dregs  of  the  Arabs  in  the  honey  of  his  Latinity." 
But  I  could  wish  that  more  modern  authorities  had  not 
been  overlooked.  On  this  point,  for  instance,  among 
the  numerous  facts  disproving  the  statement,  the 
"American  Journal  of  Medical  Sciences,"  published 
not  far  from  his  lecture-room,  would  have  presented 
him  with  a  respectable  catalogue  of  such  cases.  Thus 
he  might  refer  to  Mr.  Storrs's  paper  "  On  the  Conta 
gious  Effects  of  Puerperal  Fever  on  the  Male  Subject ; 
or  on  Persons  not  Childbearing  "  (Jan.  1846),  or  to 
Dr.  Reid's  case  (April,  1846),  or  to  Dr.  Barren's 
statement  of  the  children's  dying  of  peritonitis  in  an 
epidemic  of  puerperal  fever  at  the  Philadelphia  Hos 
pital  (Oct.  1842),  or  to  various  instances  cited  hi  Dr. 
Kneeland's  article  (April,  1846).  Or,  if  he  would 
have  referred  to  the  "  New  York  Journal,"  he  might 
have  seen  Prof.  Austin  Flint's  cases.  Or,  if  he  had 
honored  my  Essay  so  far,  he  might  have  found  strik 
ing  instances  of  the  same  kind  in  the  first  of  the  new 
series  of  cases  there  reported  and  elsewhere.  I  do  not 
see  the  bearing  of  his  proposition,  if  it  were  true. 
But  it  is  one  of  those  assertions  that  fall  hi  a  moment 
before  a  slight  examination  of  the  facts ;  and  I  con 
fess  my  surprise,  that  a  professor  who  lectures  on  the 
Diseases  of  Women  should  have  ventured  to  make  it. 
Nearly  seven  pages  are  devoted  to  showing  that  I 
was  wrong  in  saying  I  would  not  be  "  understood  to 
imply  that  there  exists  a  doubt  in  the  mind  of  any 
well-informed  member  of  the  medical  profession  as  to 
the  fact  that  puerperal  fever  is  sometimes  eommuni- 


THE  CONTAGIOUSNESS  OF  PUERPERAL  FEVER.  123 

cated  from  one  person  to  another,  both  directly  and 
indirectly."  I  will  devote  seven  lines  to  these  seven 
pages,  which  seven  lines,  if  I  may  say  it  without  of 
fence,  are,  as  it  seems  to  me,  six  more  than  are  strictly 
necessary. 

The  following  authors  are  cited  as  sceptics  by  Dr. 
Meigs  :  — 

Dewees.  —  I  cited  the  same  passage.  Did  not 
know  half  the  facts.  .  ^Robert  Lee.  —  Believes  the  dis 
ease  is  sometimes  communicable  by  contagion.  Ton- 


Baudelocque.  —  Both  cited  by        Continental 
me.     Jacquemier.  —  Published    three  writers 

years   after  my  Essay.     Kiwisch.  —  >       not  well 
Behindhand  in  knowledge  of  Puerperal        informed  on 
Fever."    Paul  Dubois.  —  Scanzoni.   J      this  Point* 

The  story  of  Von  Busch  is  of  interest  and  value, 
but  there  is  nothing  in  it  which  need  perplex  the  stu 
dent.  It  is  not  pretended  that  the  disease  is  always, 
or  even,  it  may  be,  in  the  majority  of  cases,  carried 
about  by  attendants  ;  only  that  it  is  so  carried  in  cer 
tain  cases.  That  it  may  have  local  and  epidemic 
causes,  as  well  as  that  depending  on  personal  trans 
mission,  is  not  disputed.  Remember  how  small-pox 
often  disappears  from  a  community  in  spite  of  its  con 
tagious  character,  and  the  necessary  exposure  of  many 
persons  to  those  suffering  from  it;  in  both  diseases 
contagion  is  only  one  of  the  coefficients  of  the  disease. 

I  have  already  spoken  of  the  possibility  that  Dr. 
Meigs  may  have  been  the  medium  of  transfer  of  puer 
peral  fever  in  some  of  the  cases  he  has  briefly  cata 
logued.  Of  Dr.  Rutter's  cases  I  do  not  know  how  to 

•  B.  §•  F.  Med.  Rev.  Jan.  1842. 

*  See  Dr.  Simpson's  Remarks  at  Meeting  of  Edin.  Med.  Chir. 
Soc.     (4ro.  Jour.  Oct.  1851.) 


124  MEDICAL  ESSAYS. 

speak.  I  only  ask  the  student  to  read  the  facts  stated 
by  Dr.  Condie,  as  given  in  my  Essay,  and  say  whether 
or  not  a  man  should  allow  his  wife  to  be  attended  by 
a  practitioner  in  whose  hands  "  scarcely  a  female  that 
has  been  delivered  for  weeks  past  has  escaped  an  at 
tack,"  "  while  no  instance  of  the  disease  has  occurred 
in  the  patients  of  any  other  accoucheur  practising  in 
the  same  district."  If  I  understand  Dr.  Meigs  and 
Dr.  Hodge,  they  would  not  warn  the  physician  or 
spare  the  patient  under  such  circumstances.  They 
would  "  go  on,"  if  I  understand  them,  not  to  seven,  or 
seventy,  only,  but  to  seventy  times  seven,  if  they  could 
find  patients.  If  this  is  not  what  they  mean,  may  we 
respectfully  ask  them  to  state  what  they  do  mean,  to 
their  next  classes,  in  the  name  of  humanity,  if  not  of 
science ! 

I  might  repeat  the  question  asked  concerning  Dr. 
Rutter's  cases,  with  reference  to  those  reported  by  Dr. 
Roberton.  Perhaps,  however,  the  student  would  like 
to  know  the  opinion  of  a  person  in  the  habit  of  work 
ing  at  matters  of  this  kind  in  a  practical  point  of  view. 
To  satisfy  him  on  this  ground,  I  addressed  the  follow 
ing  question  to  the  President  of  one  of  our  principal 
Insurance  Companies,  leaving  Dr.  Meigs's  book  and 
my  Essay  in  his  hands  at  the  same  time. 

Question.  "  If  such  facts  as  Roberton's  cases  were 
before  you,  and  the  attendant  had  had  ten,  or  even 
five  fatal  cases,  or  three,  or  two  even,  would  you,  or 
would  you  not,  if  insuring  the  life  of  the  next  patient 
to  be  taken  care  of  by  that  attendant,  expect  an  extra 
premium  over  that  of  an  average  case  of  childbirth  ?  " 

Answer.  "  Of  course  I  should  require  a  very  large 
extra  premium,  if  I  would  take  the  risk  at  all." 

But  I  do  not  choose  to  add  the  expressions  of  indig- 


THE   CONTAGIOUSNESS   OP  PUERPERAL  FEVER.    125 

nation  which  the  examination  of  the  facts  before  him 
called  out.  I  was  satisfied  from  the  effect  they  pro 
duced  on  him,  that  if  all  the  hideous  catalogues  of 
cases  now  accumulated  were  fully  brought  to  the 
knowledge  of  the  public,  nothing,  since  the  days  of 
Burke  and  Hare,  has  raised  such  a  cry  of  horror  as 
would  be  shrieked  in  the  ears  of  the  Profession. 

Dr.  Meigs  has  elsewhere  invoked  "  Providence  "  as 
the  alternative  of  accident,  to  account  for  the  "  coin 
cidences."  ("  Obstetrics,"  Phil.  1852,  p.  631.)  If  so, 
Providence  either  acts  through  the  agency  of  second 
ary  causes,  as  in  other  diseases,  or  not.  If  through 
such  causes,  let  us  find  out  what  they  are,  as  we  try  to 
do  in  other  cases.  It  may  be  true  that  offences,  or 
diseases,  will  come,  but  "  woe  unto  him  through  whom 
they  come,"  if  we  catch  him  in  the  voluntary  or  care 
less  act  of  bringing  them!  But  if  Providence  does 
not  act  through  secondary  causes  in  this  particular 
sphere  of  etiology,  then  why  does  Dr.  Meigs  take  such 
pains  to  reason  so  extensively  about  the  laws  of  con 
tagion,  which,  on  that  supposition,  have  no  more  to  do 
with  this  case  than  with  the  plague  which  destroyed 
the  people  after  David  had  numbered  them  ?  Above 
all,  what  becomes  of  the  theological  aspect  of  the  ques 
tion,  when  he  asserts  that  a  practitioner  was  "  only 
unlucky  in  meeting  with  the  epidemic  cases  ?  "  (  Op. 
cit.  p.  633.)  We  do  not  deny  that  the  God  of  battles 
decides  the  fate  of  nations ;  but  we  like  to  have  the 
biggest  squadrons  on  our  side,  and  we  are  particular 
that  our  soldiers  should  not  only  say  their  prayers,  but 
also  keep  their  powder  dry.  We  do  not  deny  the 
agency  of  Providence  in  the  disaster  at  Norwalk,  but 
we  turn  off  the  engineer,  and  charge  the  Company  five 
thousand  dollars  apiece  for  every  life  that  is  sacrificed. 


126  MEDICAL  ESSAYS. 

Why  a  grand  jury  should  not  bring  in  a  bill  against  a 
physician  who  switches  off  a  score  of  women  one  after 
the  other  along  his  private  track,  when  he  knows  that 
there  is  a  black  gulf  at  the  end  of  it,  down  which  they 
are  to  plunge,  while  the  great  highway  is  clear,  is  more 
than  I  can  answer.  It  is  not  by  laying  the  open  draw 
to  Providence  that  he  is  to  escape  the  charge  of  man 
slaughter. 

To  finish  with  all  these  lesser  matters  of  question, 
I  am  unable  to  see  why  a  female  must  necessarily  be 
unattended  in  her  confinement,  because  she  declines 
the  services  of  a  particular  practitioner.  In  all  the 
series  of  cases  mentioned,  the  death-carrying  attend 
ant  was  surrounded  by  others  not  tracked  by  disease 
and  its  consequences.  Which,  I  would  ask,  is  worse, 
—  to  call  in  another,  even  a  rival  practitioner,  or  to 
submit  an  unsuspecting  female  to  a  risk  which  an  In* 
surance  Company  would  have  nothing  to  do  with  ? 

I  do  not  expect  ever  to  return  to  this  subject. 
There  is  a  point  of  mental  saturation,  beyond  which 
argument  cannot  be  forced  without  breeding  impatient, 
if  not  harsh,  feelings  towards  those  who  refuse  to  be 
convinced.  If  I  have  so  far  manifested  neither,  it  is 
well  to  stop  here,  and  leave  the  rest  to  those  younger 
friends  who  may  have  more  stomach  for  the  dregs  of 
a  stale  argument. 

The  extent  of  my  prefatory  remarks  may  lead  some 
to  think  that  I  attach  too  much  importance  to  my  own 
Essay.  Others  may  wonder  that  I  should  expend  so 
many  words  upon  the  two  productions  referred  to,  the 
Letter  and  the  Lecture.  I  do  consider  my  Essay  of 
much  importance  so  long  as  the  doctrine  it  maintains 
is  treated  as  a  question,  and  so  long  as  any  important 


THE  CONTAGIOUSNESS  OF  PUERPERAL  FEVER.  127 

part  of  the  defence  of  that  doctrine  is  thought  to  rest 
on  its  evidence  or  arguments.  I  cannot  treat  as  in 
significant  any  opinions  bearing  on  life,  and  interests 
dearer  than  life,  proclaimed  yearly  to  hundreds  of 
young  men,  who  will  carry  them  to  their  legitimate 
results  in  practice. 

The  teachings  of  the  two  Professors  in  the  great 
schools  of  Philadelphia  are  sure  to  be  listened  to,  not 
only  by  their  immediate  pupils,  but  by  the  Profession 
at  large.  I  am  too  much  in  earnest  for  either  humil 
ity  or  vanity,  but  I  do  entreat  those  who  hold  the  keys 
of  life  and  death  to  listen  to  me  also  for  this  once. 
I  ask  no  personal  favor  ;  but  I  beg  to  be  heard  in  be 
half  of  the  women  whose  lives  are  at  stake,  until  some 
stronger  voice  shall  plead  for  them. 

I  trust  that  I  have  made  the  issue  perfectly  distinct 
and  intelligible.  And  let  it  be  remembered  that  this 
is  no  subject  to  be  smoothed  over  by  nicely  adjusted 
phrases  of  half-assent  and  half-censure  divided  be 
tween  the  parties.  The  balance  must  be  struck  boldly 
and  the  result  declared  plainly.  If  I  have  been  hasty, 
presumptuous,  ill-informed,  illogical ;  if  my  array  of 
facts  means  nothing ;  if  there  is  no  reason  for  any 
caution  in  the  view  of  these  facts  ;  let  me  be  told  so  on 
such  authority  that  I  must  believe  it,  and  I  will  be 
silent  henceforth,  recognizing  that  my  mind  is  in  a 
state  of  disorganization.  If  the  doctrine  I  have  main 
tained  is  a  mournful  truth ;  if  to  disbelieve  it,  and  to 
practise  on  this  disbelief,  and  to  teach  others  so  to  dis 
believe  and  practise,  is  to  carry  desolation,  and  to 
charter  others  to  carry  it,  into  confiding  families,  let 
it  be  proclaimed  as  plainly  what  is  to  be  thought  of 
the  teachings  of  those  who  sneer  at  the  alleged  dan 
gers,  and  scout  the  very  idea  of  precaution.  Let  it  be 


128  MEDICAL   ESSAYS. 

remembered  that  persons  are  nothing  in  this  matter  j 
better  that  twenty  pamphleteers  should  be  silenced,  or 
as  many  professors  unseated,  than  that  one  mother's 
life  should  be  taken.  There  is  no  quarrel  here  be 
tween  men,  but  there  is  deadly  incompatibility  and 
exterminating  warfare  between  doctrines.  Coinci 
dences,  meaning  nothing,  though  a  man  have  a  mo 
nopoly  of  the  disease  for  weeks  or  months ;  or  cause 
and  effect,  the  cause  being  in  some  way  connected 
with  the  person ;  this  is  the  question.  If  I  am  wrong, 
let  me  be  put  down  by  such  a  rebuke  as  no  rash  de- 
claimer  has  received  since  there  has  been  a  public 
opinion  in  the  medical  profession  of  America ;  if  I  am 
right,  let  doctrines  which  lead  to  professional  homicide 
be  no  longer  taught  from  the  chairs  of  those  two  great 
Institutions.  Indifference  will  not  do  here ;  our  Jour 
nalists  and  Committees  have  no  right  to  take  up  their 
pages  with  minute  anatomy  and  tediously  detailed 
cases,  while  it  is  a  question  whether  or  not  the  "  black- 
death"  of  child-bed  is  to  be  scattered  broadcast  by  the 
agency  of  the  mother's  friend  and  adviser.  Let  the 
men  who  mould  opinions  look  to  it ;  if  there  is  any 
voluntary  blindness,  any  interested  oversight,  any  cul 
pable  negligence,  even,  in  such  a  matter,  and  the  facts 
shall  reach  the  public  ear;  the  pestilence-carrier  of 
the  lying-in  chamber  must  look  to  God  for  pardon, 
for  man  will  never  forgive  him. 

THE  CONTAGIOUSNESS   OF  PUERPERAL  FEVER. 

IN  collecting,  enforcing,  and  adding  to  the  evidence 
accumulated  upon  this  most  serious  subject,  I  would 
not  be  understood  to  imply  that  there  exists  a  doubt  in 
the  mind  of  any  well-informed  member  of  the  medical 


THE  CONTAGIOUSNESS  OF  PUERPERAL  FEVER.  129 

profession  as  to  the  fact  that  puerperal  fever  is  some 
times  communicated  from  one  person  to  another,  both 
directly  and  indirectly.  In  the  present  state  of  our 
knowledge  upon  this  point  I  should  consider  such 
doubts  merely  as  a  proof  that  the  sceptic  had  either 
not  examined  the  evidence,  or,  having  examined  it,  re 
fused  to  accept  its  plain  and  unavoidable  consequences. 
I  should  be  sorry  to  think,  with  Dr.  Rigby,  that  it  was 
a  case  of  "  oblique  vision ; "  I  should  be  unwilling 
to  force  home  the  argumentum  ad  hominem  of  Dr. 
Blundell,  but  I  would  not  consent  to  make  a  ques 
tion  of  a  momentous  fact  which  is  no  longer  to  be 
considered  as  a  subject  for  trivial  discussions,  but  to 
be  acted  upon  with  silent  promptitude.  It  signifies 
nothing  that  wise  and  experienced  practitioners  have 
sometimes  doubted  the  reality  of  the  danger  in  ques 
tion  ;  no  man  has  the  right  to  doubt  it  any  longer. 
No  negative  facts,  no  opposing  opinions,  be  they  what 
they  may,  or  whose  they  may,  can  form  any  answer  to 
the  series  of  cases  now  within  the  reach  of  all  who 
choose  to  explore  the  records  of  medical  science. 

If  there  are  some  who  conceive  that  any  important 
end  would  be  answered  by  recording  such  opinions,  or 
by  collecting  the  history  of  all  the  cases  they  could  find 
in  which  no  evidence  of  the  influence  of  contagion  ex 
isted,  I  believe  they  are  in  error.  Suppose  a  few 
writers  of  authority  can  be  found  to  profess  a  disbelief 
in  contagion,  —  and  they  are  very  few  compared  with 
those  who  think  differently,  —  is  it  quite  clear  that 
they  formed  their  opinions  on  a  view  of  all  the  facts, 
or  is  it  not  apparent  that  they  relied  mostly  on  their 
own  solitary  experience  ?  Still  further,  of  those  whose 
names  are  quoted,  is  it  not  true  that  scarcely  a  single 
one  could  by  any  possibility  have  known  the  half  or 


130  MEDICAL   ESSAYS. 

the  tenth  of  the  facts  bearing  on  the  subject  which 
have  reached  such  a  frightful  amount  within  the  last 
few  years  ?  Again,  as  to  the  utility  of  negative  facts, 
as  we  may  briefly  call  them,  —  instances,  namely,  in 
which  exposure  has  not  been  followed  by  disease,  —  al 
though,  like  other  truths,  they  may  be  worth  knowing, 
I  do  not  see  that  they  are  like  to  shed  any  important 
light  upon  the  subject  before  us.  Every  such  instance 
requires  a  good  deal  of  circumstantial  explanation  be 
fore  it  can  be  accepted.  It  is  not  enough  that  a  prac 
titioner  should  have  had  a  single  case  of  puerperal 
fever  not  followed  by  others.  It  must  be  known 
whether  he  attended  others  while  this  case  was  in  prog 
ress,  whether  he  went  directly  from  one  chamber  to 
others,  whether  he  took  any,  and  what  precautions.  It 
is  important  to  know  that  several  women  were  exposed 
to  infection  derived  from  the  patient,  so  that  allowance 
may  be  made  for  want  of  predisposition.  Now  if  of 
negative  facts  so  sifted  there  could  be  accumulated  a 
hundred  for  every  one  plain  instance  of  communication 
here  recorded,  I  trust  it  need  not  be  said  that  we  are 
bound  to  guard  and  watch  over  the  hundredth  tenant 
of  our  fold,  though  the  ninety  and  nine  may  be  sure 
of  escaping  the  wolf  at  its  entrance.  If  any  one  is  dis 
posed,  then,  to  take  a  hundred  instances  of  lives  en 
dangered  or  sacrificed  out  of  those  I  have  mentioned, 
and  make  it  reasonably  clear  that  within  a  similar  time 
and  compass  ten  thousand  escaped  the  same  exposure, 
I  shall  thank  him  for  his  industry,  but  I  must  be  per 
mitted  to  hold  to  my  own  practical  conclusions,  and 
beg  him  to  adopt  or  at  least  to  examine  them  also. 
Children  that  walk  in  calico  before  open  fires  are  not 
always  burned  to  death ;  the  instances  to  the  contrary 
may  be  worth  recording ;  but  by  no  means  if  they  are 


THE  CONTAGIOUSNESS  OP  PUERPERAL  FEVER.  131 

to  be  used  as  arguments  against  woollen  frocks  and 
high  fenders. 

I  am  not  sure  that  this  paper  will  escape  another  re 
mark  which  it  might  be  wished  were  founded  in  jus 
tice.  It  may  be  said  that  the  facts  are  too  generally 
known  and  acknowledged  to  require  any  formal  argu 
ment  or  exposition,  that  there  is  nothing  new  in  the 
positions  advanced,  and  no  need  of  laying  additional 
statements  before  the  Profession.  But  on  turning  to 
two  works,  one  almost  universally,  and  the  other  exten 
sively  appealed  to  as  authority  in  this  country,  I  see 
ample  reason  to  overlook  this  objection.  In  the  last 
edition  of  Dewees's  Treatise  on  the  "  Diseases  of  Fe 
males,"  it  is  expressly  said,  "  In  this  country,  under  no 
circumstance  that  puerperal  fever  has  appeared  hith 
erto,  does  it  afford  the  slightest  ground  for  the  belief 
that  it  is  contagious."  In  the  "  Philadelphia  Practice 
of  Midwifery  "  not  one  word  can  be  found  in  the  chap 
ter  devoted  to  this  disease  which  would  lead  the 
reader  to  suspect  that  the  idea  of  contagion  had  ever 
been  entertained.  It  seems  proper,  therefore,  to  re 
mind  those  who  are  in  the  habit  of  referring  to  these 
works  for  guidance,  that  there  may  possibly  be  some 
sources  of  danger  they  have  slighted  or  omitted,  quite 
as  important  as  a  trifling  irregularity  of  diet,  or  a  con 
fined  state  of  the  bowels,  and  that  whatever  confidence 
a  physician  may  have  in  his  own  mode  of  treatment, 
his  services  are  of  questionable  value  whenever  he  car 
ries  the  bane  as  well  as  the  antidote  about  his  person. 

The  practical  point  to  be  illustrated  is  the  following : 
The  disease  known  as  Puerperal  Fever  is  so  far 
contagious  as  to  be  frequently  carried  from  patient  to 
patient  by  physicians  and  nurses. 


132  MEDICAL  ESSAYS. 

Let  me  begin  by  throwing  out  certain  incidental 
questions,  which,  without  being  absolutely  essential, 
would  render  the  subject  more  complicated,  and  by 
making  such  concessions  and  assumptions  as  may  be 
fairly  supposed  to  be  without  the  pale  of  discussion. 

1.  It  is  granted  that  all  the  forms  of  what  is  called 
puerperal   fever  may  not   be,  and  probably  are  not, 
equally  contagious  or  infectious.     I  do  not  enter  into 
the  distinctions  which  have  been  drawn  by  authors, 
because  the  facts  do  not  appear  to  me  sufficient  to  es 
tablish  any  absolute  line  of  demarcation  between  such 
forms  as  may  be  propagated  by  contagion  and  those 
which  are  never  so  propagated.     This  general  result  I 
shall  only  support  by  the  authority  of  Dr.  Ramsbofr- 
ham,  who  gives,  as  the  result  of  his  experience,  that 
the  same  symptoms  belong  to  what  he  calls  the  infec 
tious  and  the  sporadic  forms  of  the  disease,  and  the 
opinion  of  Armstrong  in  his  original  Essay.   If  others 
can  show  any  such  distinction,  I  leave  it  to  them  to  do 
it.     But  there  are  cases  enough  that  show  the  preva 
lence  of  the  disease  among  the  patients  of  a  single 
practitioner  when  it  was  in  no  degree  epidemic,  in  the 
proper  sense  of  the  term.     I  may  refer  to  those  of  Mr. 
Roberton  and  of  Dr.  Peirson,  hereafter  to  be  cited,  as 
examples. 

2.  I  shall  not  enter  into  any  dispute  about  the  par 
ticular  mode  of  infection,  whether  it  be  by  the  atmos 
phere  the  physician  carries  about  him  into  the  sick- 
chamber,  or  by  the  direct  application  of  the  virus  to 
the  absorbing  surfaces  with  which  his  hand  comes  in 
contact.      Many  facts  and  opinions  are  in  favor  of 
each  of  these  modes  of  transmission.    But  it  is  obvious 
that  in  the  majority  of  cases  it  must  be  impossible  to 
decide  by  which  of  these  channels  the  disease  is  con- 


THE  CONTAGIOUSNESS  OP  PUERPERAL  FEVER.  133 

veyed,  from  the  nature  of  the  intercourse  between  the 
physician  and  the  patient. 

3.  It  is  not  pretended  that  the  contagion  of  puer 
peral  fever  must  always  be  followed  by  the  disease. 
It  is  true  of  all  contagious  diseases,  that  they  fre 
quently  spare  those  who  appear  to  be  fully  submitted 
to  their  influence.     Even  the  vaccine  virus,  fresh  from 
the  subject,  fails  every  day  to  produce  its  legitimate 
effect,  though  every  precaution  is  taken  to  insure  its 
action.     This  is  still  more  remarkably  the  case  with 
scarlet  fever  and  some  other  diseases. 

4.  It  is  granted  that  the  disease  may  be  produced 
and  variously  modified  by  many  causes  besides  con 
tagion,  and  more  especially  by  epidemic  and  endemic 
influences.     But  this  is  not  peculiar  to  the  disease  in 
question.     There  is  no  doubt  that  small-pox  is  propa 
gated  to   a  great  extent  by  contagion,  yet  it  goes 
through  the  same  periods  of  periodical  increase  and 
diminution  which  have  been  remarked  in  puerperal 
fever.     If  the  question  is  asked  how  we  are  to  recon 
cile  the  great  variations  in  the  mortality  of  puerperal 
fever  in  different  seasons  and  places  with  the  supposi 
tion  of  contagion,  I  will  answer  it  by  another  question 
from  Mr.  Farr's  letter  to  the  Registrar-General.     He 
makes  the  statement  that  "five  die  weekly  of  small-pox 
in  the  metropolis  when  the  disease  is  not  epidemic," 
—  and  adds,  "  The  problem  for  solution  is,  —  Why  do 
the  five  deaths  become  10,  15,  20,  31,  58,  88,  weekly, 
and  then  progressively  fall  through  the  same  measured 
steps  ?  " 

5.  I  take  it  for  granted,  that  if  it  can  be  shown  that 
great  numbers  of  lives  have  been  and  are  sacrificed  to 
ignorance  or  blindness  on  this  point,  no  other  error  of 
which  physicians  or  nurses  may  be  occasionally  sua- 


134  MEDICAL  ESSAYS. 

pected  will  be  alleged  in  palliation  of  this ;  but  that 
whenever  and  wherever  they  can  be  shown  to  carry 
disease  and  death  instead  of  health  and  safety,  the 
common  instincts  of  humanity  will  silence  every  at 
tempt  to  explain  away  their  responsibility. 

The  treatise  of  Dr.  Gordon  of  Aberdeen  was  pub 
lished  in  the  year  1795,  being  among  the  earlier  spec 
ial  works  upon  the  disease.  A  part  of  his  testimony 
has  been  occasionally  copied  into  other  works,  but  his 
expressions  are  so  clear,  his  experience  is  given  with 
such  manly  distinctness  and  disinterested  honesty,  that 
it  may  be  quoted  as  a  model  which  might  have  been 
often  followed  with  advantage. 

"  This  disease  seized  such  women  only  as  were  vis 
ited,  or  delivered  by  a  practitioner,  or  taken  care  of  by 
a  nurse,  who  had  previously  attended  patients  affected 
with  the  disease." 

"  I  had  evident  proofs  of  its  infectious  nature,  and 
that  the  infection  was  as  readily  communicated  as 
that  of  the  small-pox  or  measles,  and  operated  more 
speedily  than  any  other  infection  with  which  I  am 
acquainted." 

"  I  had  evident  proofs  that  every  person  who  had 
been  with  a  patient  in  the  puerperal  fever  became 
charged  with  an  atmosphere  of  infection,  which  was 
communicated  to  every  pregnant  woman  who  hap 
pened  to  come  within  its  sphere.  This  is  not  an  asser 
tion,  but  a  fact,  admitting  of  demonstration,  as  may 
be  seen  by  a  perusal  of  the  foregoing  table,"  —  refer 
ring  to  a  table  of  seventy-seven  cases,  in  many  of 
which  the  channel  of  propagation  was  evident. 

He  adds,  "  It  is  a  disagreeable  declaration  for  me  to 
mention,  that  I  myself  was  the  means  of  carrying  the 


THE  CONTAGIOUSNESS  OF  PUERPERAL  FEVER.  135 

infection  to  a  great  number  of  women."  He  then 
enumerates  a  number  of  instances  in  which  the  disease 
was  conveyed  by  midwives  and  others  to  the  neighbor 
ing  villages,  and  declares  that  "  these  facts  fully  prove 
that  the  cause  of  the  puerperal  fever,  of  which  I  treat, 
was  a  specific  contagion,  or  infection,  altogether  un 
connected  with  a  noxious  constitution  of  the  atmos-* 
phere." 

But  his  most  terrible  evidence  is  given  in  these 
words  :  "  I  ARRIVED  AT  THAT  CERTAINTY  IN  THE  MAT 
TER,  THAT  I  COULD  VENTURE  TO  FORETELL  WHAT 
WOMEN  WOULD  BE  AFFECTED  WITH  THE  DISEASE, 
UPON  HEARING  BY  WHAT  MIDWIFE  THEY  WERE  TO 
BE  DELIVERED,  OR  BY  WHAT  NURSE  THEY  WERE  TO 
BE  ATTENDED,  DURING  THEIR  LYING-IN  :  AND  ALMOST 
IN  EVERY  INSTANCE,  MY  PREDICTION  WAS  VERIFIED." 

Even  previously  to  Gordon,  Mr.  White  of  Manches 
ter  had  said,  "  I  am  acquainted  with  two  gentlemen  in 
another  town,  where  the  whole  business  of  midwifery 
is  divided  betwixt  them,  and  it  is  very  remarkable  that 
one  of  them  loses  several  patients  every  year  of  the 
puerperal  fever,  and  the  other  never  so  much  as  meets 
with  the  disorder,"  —  a  difference  which  he  seems  td 
attribute  to  their  various  modes  of  treatment." 

Dr.  Armstrong  has  given  a  number  of  instances  in 
his  Essay  on  Puerperal  Fever,  of  the  prevalence  of 
the  disease  among  the  patients  of  a  single  practitioner. 
At  Sunderland,  "  in  all,  forty-three  cases  occurred 
from  the  1st  of  January  to  the  1st  of  October,  when 
the  disease  ceased ;  and  of  this  number  forty  were  wit 
nessed  by  Mr.  Gregson  and  his  assistant,  Mr.  Gregory, 
the  remainder  having  been  separately  seen  by  three 
accoucheurs."  There  is  appended  to  the  London  edi 
"  On  the  Management  of  Lying-in  Women,  p.  120. 


136          '  MEDICAL  ESSAYS. 

tion  of  this  Essay,  a  letter  from  Mr.  Gregson,  in  which 
that  gentleman  says,  in  reference  to  the  great  number 
of  cases  occurring  in  his  practice,  "  The  cause  of  this 
I  cannot  pretend  fully  to  explain,  but  I  should  be 
wanting  in  common  liberality  if  I  were  to  make  any 
hesitation  in  asserting,  that  the  disease  which  appeared 
in  my  practice  was  highly  contagious,  and  communica 
ble  from  one  puerperal  woman  to  another."  "  It  is 
customary  among  the  lower  and  middle  ranks  of  peo 
ple  to  make  frequent  personal  visits  to  puerperal 
women  resident  in  the  same  neighborhood,  and  I  have 
ample  evidence  for  affirming  that  the  infection  of  the 
disease  was  often  carried  about  in  that  manner  ;  and, 
however  painful  to  my  feelings,  I  must  in  candor  de 
clare,  that  it  is  very  probable  the  contagion  was  con 
veyed,  in  some  instances,  by  myself,  though  I  took 
every  possible  care  to  prevent  such  a  thing  from  hap 
pening,  the  moment  that  I  ascertained  that  the  distem 
per  was  infectious."  Dr.  Armstrong  goes  on  to  men 
tion  six  other  instances  within  his  knowledge,  in  which 
the  disease  had  at  different  times  and  places  been  lim* 
ited,  in  the  same  singular  manner,  to  the  practice  of 
individuals,  while  it  existed  scarcely  if  at  all  among 
the  patients  of  others  around  them.  Two  of  the  gen 
tlemen  became  so  convinced  of  their  conveying  the 
contagion,  that  they  withdrew  for  a  time  from  practice. 

I  find  a  brief  notice,  in  an  American  Journal,  of  an 
other  series  of  cases,  first  mentioned  by  Mr.  Davies,  in 
the  "  Medical  Repository."  This  gentleman  stated  his 
conviction  that  the  disease  is  contagious. 

"  In  the  autumn  of  1822  he  met  with  twelve  cases, 
while  his  medical  friends  in  the  neighborhood  did  not 
meet  with  any,  '  or  at  least  very  few.'  He  could  at 
tribute  this  circumstance  to  no  other  cause  than  his 


THE  CONTAGIOUSNESS  OP  PUERPERAL  FEVER.  137 

having  been  present  at  the  examination,  after  death, 
of  two  cases,  some  time  previous,  and  of  his  having 
imparted  the  disease  to  his  patients,  notwithstanding 
every  precaution."  ° 

Dr.  Gooch  says,  "  It  is  not  uncommon  for  the  greater 
number  of  cases  to  occur  in  the  practice  of  one  man, 
whilst  the  other  practitioners  of  the  neighborhood,  who 
are  not  more  skilful  or  more  busy,  meet  with  few  or 
none.  A  practitioner  opened  the  body  of  a  woman 
who  had  died  of  puerperal  fever,  and  continued  to 
wear  the  same  clothes.  A  lady  whom  he  delivered  a 
few  days  afterwards  was  attacked  with  and  died  of  a 
similar  disease ;  two  more  of  his  lying-in  patients,  in 
rapid  succession,  met  with  the  same  fate ;  struck  by 
the  thought,  that  he  might  have  carried  contagion  in 
his  clothes,  he  instantly  changed  them,  and  met  with 
no  more  cases  of  the  kind.6  A  woman  in  the  country, 
who  was  employed  as  washerwoman  and  nurse,  washed 
the  linen  of  one  who  had  died  of  puerperal  fever ;  the 
next  lying-in  patient  she  nursed  died  of  the  same  dis 
ease  ;  a  third  nursed  by  her  met  with  the  same  fate, 
till  the  neighborhood,  getting  afraid  of  her,  ceased  to 
employ  her."  e 

In  the  winter  of  the  year  1824,  "  Several  instances 
occurred  of  its  prevalence  among  the  patients  of  par 
ticular  practitioners,  whilst  others  who  were  equally 
busy  met  with  few  or  none.  One  instance  of  this  kind 
was  very  remarkable.  A  general  practitioner,  in  large 
midwifery  practice,  lost  so  many  patients  from  puer- 

a  Philad.  Med.  Journal  for  1825,  p.  408. 

*  A  similar  anecdote  is  related  by  Sir  Benjamin  Brodie,  of 
the  late  Dr.  John  Clarke.     Lancet,  May  2,  1840. 

•  An  Account  of  some  of  the  most  important  Diseases  peculiar  to 
Women,  p.  4. 


J.38  MEDICAL  ESSAYS. 

peral  fever,  that  he  determined  to  deliver  no  more  fo* 
some  time,  but  that  his  partner  should  attend  in  his 
place.  This  plan  was  pursued  for  one  month,  during 
which  not  a  case  of  the  disease  occurred  in  their  prac- 
tice.  The  elder  practitioner,  being  then  sufficiently 
recovered,  returned  to  his  practice,  but  the  first  pa 
tient  he  attended  was  attacked  by  the  disease  and 
died.  A  physician,  who  met  him  in  consultation  soon 
afterwards,  about  a  case  of  a  different  kind,  and  who 
knew  nothing  of  his  misfortune,  asked  him  whether 
puerperal  fever  was  at  all  prevalent  in  his  neighbor 
hood,  on  which  he  burst  into  tears,  and  related  the 
above  circumstances. 

*'  Among  the  cases  which  I  saw  this  season  in  con 
sultation,  four  occurred  in  one  month  in  the  practice 
of  one  medical  man,  and  all  of  them  terminated  fa 
tally."  * 

Dr.  Ramsbotham  asserted,  in  a  Lecture  at  the  Lon 
don  Hospital,  that  he  had  known  the  disease  spread 
through  a  particular  district,  or  be  confined  to  the 
practice  of  a  particular  person,  almost  every  patient 
being  attacked  with  it,  while  others  had  not  a  single 
case.  It  seemed  capable,  he  thought,  of  conveyance, 
not  only  by  common  modes,  but  through  the  dress  of 
the  attendants  upon  the  patient.6 

In  a  letter  to  be  found  in  the  "London  Medical 
Gazette  "  for  January,  1840,  Mr.  Roberton  of  Man 
chester  makes  the  statement  which  I  here  give  in  a 
somewhat  condensed  form. 

A  midwife  delivered  a  woman  on  the  4th  of  Decem 
ber,  1830,  who  died  soon  after  with  the  symptoms  of 
puerperal  fever.  In  one  month  from  this  date  the 

•  Gooch,  Op.  cit.  p.  71. 

6  Land.  Med,  Gaz.  May  2,  1835. 


THE   CONTAGIOUSNESS   OF   PUERPERAL   FEVER.    139 

same  midwife  delivered  thirty  women,  residing  in 
different  parts  of  an  extensive  suburb,  of  which  num 
ber  sixteen  caught  the  disease  and  all  died.  These 
were  the  only  cases  which  had  occurred  for  a  consid 
erable  time  in  Manchester.  The  other  midwives  con 
nected  with  the  same  charitable  institution  as  the 
woman  already  mentioned  are  twenty-five  in  number, 
and  deliver,  on  an  average,  ninety  women  a  week,  or 
about  three  hundred  and  eighty  a  month.  None  of 
these  women  had  a  case  of  puerperal  fever.  "  Yet  all 
this  time  this  woman  was  crossing  the  other  midwives 
in  every  direction,  scores  of  the  patients  of  the  charity 
being  delivered  by  them  in  the  very  same  quarters 
where  her  cases  of  fever  were  happening." 

Mr.  Roberton  remarks,  that  little  more  than  half 
the  women  she  delivered  during  this  month  took  the 
fever ;  that  on  some  days  all  escaped,  on  others  only 
one  or  more  out  of  three  or  four ;  a  circumstance  sim 
ilar  to  what  is  seen  in  other  infectious  maladies. 

Dr.  Blundell  says,  "Those  who  have  never  made 
the  experiment  can  have  but  a  faint  conception  how 
difficult  it  is  to  obtain  the  exact  truth  respecting  any 
occurrence  in  which  feelings  and  interests  are  con 
cerned.  Omitting  particulars,  then.  I  content  myself 
with  remarking,  generally,  that  from  more  than  one 
district  I  have  received  accounts  of  the  prevalence  of 
puerperal  fever  in  the  practice  of  some  individuals, 
while  its  occurrence  in  that  of  others,  in  the  same  < 
neighborhood,  was  not  observed.  Some,  as  I  have 
been  told,  have  lost  ten,  twelve,  or  a  greater  number 
of  patients,  in  scarcely  broken  succession  ;  like  their 
evil  genius,  the  puerperal  fever  has  seemed  to  stalk 
behind  them  wherever  they  went.  Some  have  deemed 
it  prudent  to  retire  for  a  time  from  practice.  In  fine, 


140  MEDICAL  ESSAYS. 

that  this  fever  may  occur  spontaneously,  I  admit; 
that  its  infectious  nature  may  be  plausibly  disputed, 
I  do  not  deny ;  but  I  add,  considerately,  that  in  my 
own  family  I  had  rather  that  those  I  esteemed  the 
most  should  be  delivered,  unaided,  in  a  stable,  by  the 
manger-side,  than  that  they  should  receive  the  best 
help,  in  the  fairest  apartment,  but  exposed  to  the  va 
pors  of  this  pitiless  disease.  Gossiping  friends,  wet- 
nurses,  monthly  nurses,  the  practitioner  himself,  these 
are  the  channels  by  which,  as  I  suspect,  the  infection 
is  principally  conveyed."  a 

At  a  meeting  of  the  Royal  Medical  and  Chirurgical 
Society,  Dr.  King  mentioned  that  some  years  since  a 
practitioner  at  Woolwich  lost  sixteen  patients  from 
puerperal  fever  in  the  same  year.  He  was  compelled 
to  give  up  practice  for  one  or  two  years,  his  business 
being  divided  among  the  neighboring  practitioners. 
No  case  of  puerperal  fever  occurred  afterwards,  nei 
ther  had  any  of  the  neighboring  surgeons  any  cases  of 
this  disease. 

At  the  same  meeting  Mr.  Hutchinson  mentioned 
the  occurrence  of  three  consecutive  cases  of  puerperal 
fever,  followed  subsequently  by  two  others,  all  in  the 
practice  of  one  accoucheur.6 

Dr.  Lee  makes  the  following  statement :  "  In  the 
last  two  weeks  of  September,  1827,  five  fatal  cases  of 
uterine  inflammation  came  under  our  observation. 
All  the  individuals  so  attacked  had  been  attended  in 
labor  by  the  same  midwife,  and  no  example  of  a  febrile 
or  inflammatory  disease  of  a  serious  nature  occurred 
during  that  period  among  the  other  patients  of  the 
Westminster  General  Dispensary,  who  had  been  at- 

•  Lect.  on  Midwifery,  p.  395. 

*  Lancet,  May  2,  1840. 


THE  CONTAGIOUSNESS   OP  PUERPERAL   FEVER.    141 

tended  by  the  other  midwives  belonging  to  that  insti 
tution.  "  a 

The  recurrence  of  long  series  of  cases  like  those  I 
have  cited,  reported  by  those  most  interested  to  dis 
believe  in  contagion,  scattered  along  through  an  inter 
val  of  half  a  century,  might  have  been  thought  suffi 
cient  to  satisfy  the  minds  of  all  inquirers  that  here 
was  something  more  than  a  singular  coincidence.  But 
if,  on  a  more  extended  observation,  it  should  be  found 
that  the  same  ominous  groups  of  cases  clustering 
about  individual  practitioners  were  observed  in  a  re 
mote  country,  at  different  times,  and  in  widely  sepa 
rated  regions,  it  would  seem  incredible  that  any  should 
be  found  too  prejudiced  or  indolent  to  accept  the 
solemn  truth  knelled  into  their  ears  by  the  funeral 
bells  from  both  sides  of  the  ocean,  —  the  plain  con 
clusion  that  the  physician  and  the  disease  entered, 
hand  in  hand,  into  the  chamber  of  the  unsuspecting 
patient. 

That  such  series  of  cases  have  been  observed  in  this 
country,  and  in  this  neighborhood,  I  proceed  to  show. 

In  Dr.  Francis's  "  Notes  to  Denman's  Midwifery," 
a  passage  is  cited  from  Dr.  Hosack,  in  which  he  refers 
to  certain  puerperal  cases  which  proved  fatal  to  several 
lying-in  women,  and  in  some  of  which  the  disease  was 
supposed  to  be  conveyed  by  the  accoucheurs  them 
selves.6 

A  writer  in  the  "  New  York  Medical  and  Physical 
Journal "  for  October,  1829,  in  speaking  of  the  occur 
rence  of  puerperal  fever,  confined  to  one  man's  prac 
tice,  remarks,  "  We  have  known  cases  of  this  kind 
occur,  though  rarely,  in  New  York." 

•  Lond.  Cyc.  of  Pract.  Med.  art.  "  Fever,  Puerperal " 

*  Denman's  Midwifery,  p.  673,  3d  Am.  ed. 


142  MEDICAL  ESSAYS. 

I  mention  these  little  hints  about  the  occurrence  of 
such  cases,  partly  because  they  are  the  first  I  have 
met  with  in  American  medical  literature,  but  more 
especially  because  they  serve  to  remind  us  that  be 
hind  the  fearful  array  of  published  facts  there  lies  a 
dark  list  of  similar  events,  unwritten  in  the  records 
of  science,  but  long  remembered  by  many  a  desolated 
fireside. 

Certainly  nothing  can  be  more  open  and  explicit 
than  the  account  given  by  Dr.  Peirson  of  Salem,  of 
the  cases  seen  by  him.  In  the  first  nineteen  days  of 
January,  1829,  he  had  five  consecutive  cases  of  puer 
peral  fever,  every  patient  he  attended  being  attacked, 
and  the  three  first  cases  proving  fatal.  In  March  of 
the  same  year  he  had  two  moderate  cases,  in  June, 
another  case,  and  in  July,  another,  which  proved  fatal. 
"  Up  to  this  period,"  he  remarks,  "  I  am  not  informed 
that  a  single  case  had  occurred  in  the  practice  of  any 
other  physician.  Since  that  period  I  have  had  no 
fatal  case  in  my  practice,  although  I  have  had  sev 
eral  dangerous  cases.  I  have  attended  in  all  twenty 
cases  of  this  disease,  of  which  four  have  been  fatal. 
I  am  not  aware  that  there  has  been  any  other  case  in 
the  town  of  distinct  puerperal  peritonitis,  although  I 
am  willing  to  admit  my  information  may  be  very  de 
fective  on  this  point.  I  have  been  told  of  some  *  mixed 
cases,'  and  '  morbid  affections  after  delivery.'  "  a 

In  the  "  Quarterly  Summary  of  the  Transactions  of 
the  College  of  Physicians  of  Philadelphia  "  *  may  be 
found  some  most  extraordinary  developments  respect 
ing  a  series  of  cases  occurring  in  the  practice  of  a 
member  of  that  body. 

"  Remarks  on  Puerperal  Fever,  pp.  12  and  18. 
*  For  May,  June,  and  July,  1842. 


THE  CONTAGIOUSNESS  OF  PUERPERAL  FEVER.  143 

Dr.  Condie  called  the  attention  of  the  Society  to  the 
prevalence,  at  the  present  time,  of  puerperal  fever  of  a 
peculiarly  insidious  and  malignant  character.  "  In  the 
practice  of  one  gentleman  extensively  engaged  as  an 
obstetrician,  nearly  every  female  he  has  attended  in 
confinement,  during  several  weeks  past,  within  the 
above  limits  "  (the  southern  sections  and  neighboring 
districts),  "  had  been  attacked  by  the  fever." 

"  An  important  query  presents  itself,  the  Doctor  ob 
served,  in  reference  to  the  particular  form  of  fever  now 
prevalent.  Is  it,  namely,  capable  of  being  propagated 
by  contagion,  and  is  a  physician  who  has  been  in  at 
tendance  upon  a  case  of  the  disease  warranted  in 
continuing,  without  interruption,  his  practice  as  an 
obstetrician  ?  Dr.  C.,  although  not  a  believer  in  the 
contagious  character  of  many  of  those  affections  gener 
ally  supposed  to  be  propagated  in  this  manner,  has 
nevertheless  become  convinced  by  the  facts  that  have 
fallen  under  his  notice,  that  the  puerperal  fever  now 
prevailing  is  capable  of  being  communicated  by  con 
tagion.  How  otherwise  can  be  explained  the  very 
curious  circumstance  of  the  disease  in  one  district  being 
exclusively  confined  to  the  practice  of  a  single  phy 
sician,  a  Fellow  of  this  College,  extensively  engaged  in 
obstetrical  practice,  —  while  no  instance  of  the  disease 
has  occurred  in  the  patients  under  the  care  of  any 
other  accoucheur  practising  within  the  same  district ; 
scarcely  a  female  that  has  been  delivered  for  weeks 
past  has  escaped  an  attack?  " 

Dr.  Butter,  the  practitioner  referred  to,  "  observed 
that,  after  the  occurrence  of  a  number  of  cases  of  the 
disease  in  his  practice,  he  had  left  the  city  and  re 
mained  absent  for  a  week,  but  on  returning,  no  art 
icle  of  clothing  he  then  wore  having  been  used  by  him 


144  MEDICAL  ESSAYS. 

before,  one  of  the  very  first  cases  of  parturition  he  at- 
tended  was  followed  by  an  attack  of  the  fever,  and  ter 
minated  fatally ;  he  cannot,  readily,  therefore,  believe 
in  the  transmission  of  the  disease  from  female  to  fe 
male,  in  the  person  or  clothes  of  the  physician." 

The  meeting  at  which  these  remarks  were  made  was 
held  on  the  3d  of  May,  1842.  In  a  letter  dated  De 
cember  20,  1842,  addressed  to  Dr.  Meigs,  and  to  be 
found  in  the  "  Medical  Examiner,"  a  he  speaks  of  "  those 
horrible  cases  of  puerperal  fever,  some  of  which  you 
did  me  the  favor  to  see  with  me  during  the  past  sum 
mer,"  and  talks  of  his  experience  in  the  disease,  "  now 
numbering  nearly  seventy  cases,  all  of  which  have  oc 
curred  within  less  than  a  twelvemonth  past." 

And  Dr.  Meigs  asserts,  on  the  same  page,  "  Indeed, 
I  believe  that  his  practice  in  that  department  of  the 
profession  was  greater  than  that  of  any  other  gentle 
man,  which  was  probably  the  cause  of  his  seeing  a 
greater  number  of  the  cases."  This  from  a  professor 
of  midwifery,  who  some  time  ago  assured  a  gentleman 
whom  he  met  in  consultation,  that  the  night  on  which 
they  met  was  the  eighteenth  in  succession  that  he  him 
self  had  been  summoned  from  his  repose,6  seems 
hardly  satisfactory. 

I  must  call  the  attention  of  the  inquirer  most  par 
ticularly  to  the  Quarterly  Report  above  referred  to, 
and  the  letters  of  Dr.  Meigs  and  Dr.  Rutter,  to  be 
found  in  the  "  Medical  Examiner."  Whatever  impres 
sion  they  may  produce  upon  his  mind,  I  trust  they  will 
at  least  convince  him  that  there  is  some  reason  for 
looking  into  this  apparently  uninviting  subject. 

At  a  meeting  of  the  College  of  Physicians  just  men- 

"  For  January  21,  1843. 

*  Medical  Examiner  for  December  10,  1842. 


THE  CONTAGIOUSNESS  OF  PUERPERAL  FEVER.  145 

tioned,  Dr.  Warrington  stated,  that  a  few  days  after 
assisting  at  an  autopsy  of  puerperal  peritonitis,  in 
which  he  laded  out  the  contents  of  the  abdominal  cav 
ity  with  his  hands,  he  was  called  upon  to  deliver  three 
women  in  rapid  succession.  All  of  these  women  were 
attacked  with  different  forms  of  what  is  commonly 
called  puerperal  fever.  Soon  after  these  he  saw  two 
other  patients,  both  on  the  same  day,  with  the  same 
disease.  Of  these  five  patients  two  died. 

At  the  same  meeting,  Dr.  West  mentioned  a  fact 
related  to  him  by  Dr.  Samuel  Jackson  of  Northum 
berland.  Seven  females,  delivered  by  Dr.  Jackson  in 
rapid  succession,  while  practising  in  Northumberland 
County,  were  all  attacked  with  puerperal  fever,  and 
five  of  them  died.  "  Women,"  he  said,  "  who  had  ex 
pected  me  to  attend  upon  them,  now  becoming  alarmed, 
removed  out  of  my  reach,  and  others  sent  for  a  physi 
cian  residing  several  miles  distant.  These  women,  as 
well  as  those  attended  by  midwives,  all  did  well ;  nor 
did  we  hear  of  any  deaths  in  child-bed  within  a  radius 
of  fifty  miles,  excepting  two,  and  these  I  afterwards 
ascertained  to  have  been  caused  by  other  diseases." 
He  underwent,  as  he  thought,  a  thorough  purification, 
and  still  his  next  patient  was  attacked  with  the  disease 
and  died.  He  was  led  to  suspect  that  the  contagion 
might  have  been  carried  in  the  gloves  which  he  had 
worn  in  attendance  upon  the  previous  cases.  Two 
months  or  more  after  this  he  had  two  other  cases.  He 
could  find  nothing  to  account  for  these,  unless  it  were 
the  instruments  for  giving  enemata,  which  had  been 
used  in  two  of  the  former  cases,  and  were  employed  by 
these  patients.  When  the  first  case  occurred,  he  was 
attending  and  dressing  a  limb  extensively  mortified 
from  erysipelas,  and  went  immediately  to  the  accouche- 


146  MEDICAL  ESSAYS. 

ment  with  his  clothes  and  gloves  most  thoroughly 
imbued  with  its  effluvia.  And  here  I  may  mention, 
that  this  very  Dr.  Samuel  Jackson  of  Northumber 
land  is  one  of  Dr.  Dewees's  authorities  against  con 
tagion. 

The  three  following  statements  are  now  for  the  first 
time  given  to  the  public.  All  of  the  cases  referred  to 
occurred  within  this  State,  and  two  of  the  three  series 
in  Boston  and  its  immediate  vicinity. 

I.  The  first  is  a  series  of  cases  which  took  place 
during  the  last  spring  in  a  town  at  some  distance  from 
this  neighborhood.  A  physician  of  that  town,  Dr.  C., 
had  the  following  consecutive  cases. 

No.  1,  delivered  March  20,  died  March  24. 
"  2,  "  April  9,  "  April  14. 
"  3,  "  "  10,  "  "  14. 

"   4,        "  "      11,    "        "      18. 

"    5,         "  "       27,  May       3. 

"    6,         "  "       28,  had  some  symptoms, 

[recovered. 

"    7,         "        May       8,  had  some  symptoms, 

[also  recovered. 

These  were  the  only  cases  attended  by  this  physi 
cian  during  the  period  referred  to.  "  They  were  all 
attended  by  him  until  their  termination,  with  the  ex 
ception  of  the  patient  No.  6,  who  fell  into  the  hands 
of  another  physician  on  the  2d  of  May.  (Dr.  C.  left 
town  for  a  few  days  at  this  time.)  Dr.  C.  attended 
cases  immediately  before  and  after  the  above-named 
periods,  none  of  which,  however,  presented  any  pe 
culiar  symptoms  of  the  disease. 

About  the  1st  of  July  he  attended  another  patient 


THE  CONTAGIOUSNESS  OF  PUERPERAL  FEVER.  147 

in  a  neighboring  village,  who  died  two  or  three  days 
after  delivery. 

The  first  patient,  it  is  stated,  was  delivered  on  the 
20th  of  March.  "On  the  19th,  Dr.  C.  made  the 
autopsy  of  a  man  who  died  suddenly,  sick  only  forty- 
eight  hours ;  had  oadema  of  the  thigh,  and  gangrene 
extending  from  a  little  above  the  ankle  into  the  cavity 
of  the  abdomen."  Dr.  C.  wounded  himself,  very 
slightly,  in  the  right  hand  during  the  autopsy.  The 
hand  was  quite  painful  the  night  following,  during  his 
attendance  on  the  patient  No.  1.  He  did  not  see  this 
patient  after  the  20th,  being  confined  to  the  house, 
and  very  sick  from  the  wound  just  mentioned,  from 
this  time  until  the  3d  of  April. 

Several  cases  of  erysipelas  occurred  in  the  house 
where  the  autopsy  mentioned  above  took  place,  soon 
after  the  examination.  There  were  also  many  cases 
of  erysipelas  in  town  at  the  tune  of  the  fatal  puerperal 
cases  which  have  been  mentioned. 

The  nurse  who  laid  oui,  the  body  of  the  patient  No. 

3  was  taken  on  the  evening  of  the  same  day  with  sore 
throat  and  erysipelas,  and  died  in  ten  days  from  the 
first  attack. 

The  nurse  who  laid  out  the  body  of  the  patient  No. 

4  was  taken  on  the  day  following  with  symptoms  like 
those  of  this  patient,  and  died  in  a  week,  without  any 
external  marks  of  erysipelas. 

"  No  other  cases  of  similar  character  with  those  of 
Dr.  C.  occurred  in  the  practice  of  any  of  the  physicians 
in  the  town  or  vicinity  at  the  time.  Deaths  following 
confinement  have  occurred  in  the  practice  of  other 
physicians  during  the  past  year,  but  they  were  not 
cases  of  puerperal  fever.  No  post-mortem  examina 
tions  were  held  in  any  of  these  puerperal  cases." 


148  MEDICAL  ESSAYS. 

Some  additional  statements  in  this  letter  are  deserv 
ing  of  insertion. 

"  A  physician  attended  a  woman  in  the  immediate 
neighborhood  of  the  cases  numbered  2,  3,  and  4. 
This  patient  was  confined  the  morning  of  March  1st, 
and  died  on  the  night  of  March  7th.  It  is  doubtful 
whether  this  should  be  considered  a  case  of  puerperal 
fever.  She  had  suffered  from  canker,  indigestion,  and 
diarrhoea  for  a  year  previous  to  her  delivery.  Her 
complaints  were  much  aggravated  for  two  or  three 
months  previous  to  delivery  ;  she  had  become  greatly 
emaciated,  and  weakened  to  such  an  extent  that  it 
had  not  been  expected  that  she  would  long  survive  her 
confinement,  if  indeed  she  reached  that  period.  Her 
labor  was  easy  enough ;  she  flowed  a  good  deal,  seemed 
exceedingly  prostrated,  had  ringing  in  the  ears,  and 
other  symptoms  of  exhaustion  ;  the  pulse  was  quick  and 
small.  On  the  second  and  third  day  there  was  some 
tenderness  and  tumefaction  of  the  abdomen,  which  in 
creased  somewhat  on  the  fourth  and  fifth.  He  had 
cases  in  midwifery  before  and  after  this,  which  pre 
sented  nothing  peculiar." 

It  is  also  mentioned  in  the  same  letter,  that  another 
physician  had  a  case  during  the  last  summer  and  an 
other  last  fall,  both  of  which  recovered. 

Another  gentleman  reports  a  case  last  December,  a 
second  case  five  weeks,  and  another  three  weeks  since. 
All  these  recovered.  A  case  also  occurred  very  re 
cently  in  the  practice  of  a  physician  in  the  village 
where  the  eighth  patient  of  Dr.  C.  resides,  which 
proved  fatal.  "  This  patient  had  some  patches  of  ery 
sipelas  on  the  legs  and  arms.  The  same  physician  has 
delivered  three  cases  since,  which  have  all  done  well 
There  have  been  no  other  cases  in  this  town  or  its  vi 


THE  CONTAGIOUSNESS  OF  PUERPERAL  FEVER.  149 

cinity  recently.  There  have  been  some  few  cases  of 
erysipelas."  It  deserves  notice  that  the  partner  of  Dr. 
C.,  who  attended  the  autopsy  of  the  man  above  men 
tioned  and  took  an  active  part  in  it ;  who  also  suffered 
very  slightly  from  a  prick  under  the  thumb-nail  re 
ceived  during  the  examination,  had  twelve  cases  of 
midwifery  between  March  26th  and  April  12th,  all  of 
which  did  well,  and  presented  no  peculiar  symptoms. 
It  should  also  be  stated,  that  during  these  seventeen 
days  he  was  in  attendance  on  all  the  cases  of  erysipe 
las  in  the  house  where  the  autopsy  had  been  per 
formed. 

I  owe  these  facts  to  the  prompt  kindness  of  a  gen 
tleman  whose  intelligence  and  character  are  sufficient 
guaranty  for  their  accuracy. 

The  two  following  letters  were  addressed  to  my 
friend  Dr.  Storer,  by  the  gentleman  in  whose  practice 
the  cases  of  puerperal  fever  occurred.  His  name  ren 
ders  it  unnecessary  to  refer  more  particularly  to  these 
gentlemen,  who  on  their  part  have  manifested  the 
most  perfect  freedom  and  courtesy  in  affording  these 
accounts  of  their  painful  experience. 

"January  28,  1843. 

II.  ...  "The  time  to  which  you  allude  was  in 
1830.  The  first  case  was  in  February,  during  a  very 
cold  time.  She  was  confined  the  4th,  and  died  the 
12th.  Between  the  10th  and  28th  of  this  month,  I  at 
tended  six  women  in  labor,  all  of  whom  did  well  ex 
cept  the  last,  as  also  two  who  were  confined  March  1st 
and  5th.  Mrs.  E.,  confined  February  28th,  sickened, 
and  died  March  8th.  The  next  day,  9th,  I  inspected 
the  body,  and  the  night  after  attended  a  lady,  Mrs. 
B.,  who  sickened,  and  died  16th.  The  10th,  I  at 


150  MEDICAL   ESSAYS. 

tended  another,  Mrs.  G.,  who  sickened,  but  recovered. 
March  16th,  I  went  from  Mrs.  G.'s  room  to  attend  a 
Mrs.  H.,  who  sickened,  and  died  21st.  The  17th,  I 
inspected  Mrs.  B.  On  the  19th,  I  went  directly  from 
Mrs.  H.'s  room  to  attend  another  lady,  Mrs.  G.,  who 
also  sickened,  and  died  22d.  While  Mrs.  B.  was  sick, 
on  15th,  I  went  directly  from  her  room  a  few  rods,  and 
attended  another  woman,  who  was  not  sick.  Up  to 
20th  of  this  month  I  wore  the  same  clothes.  I  now 
refused  to  attend  any  labor,  and  did  not  till  April 
21st,  when,  having  thoroughly  cleansed  myself,  I  re 
sumed  my  practice,  and  had  no  more  puerperal  fever. 

"The  cases  were  not  confined  to  a  narrow  space. 
The  two  nearest  were  half  a  mile  from  each  other,  and 
half  that  distance  from  my  residence.  The  others 
were  from  two  to  three  miles  apart,  and  nearly  that 
distance  from  my  residence.  There  were  no  other 
cases  in  their  immediate  vicinity  which  came  to  my 
knowledge.  The  general  health  of  all  the  women  was 
pretty  good,  and  all  the  labors  as  good  as  common, 
except  the  first.  This  woman,  in  consequence  of  my 
not  arriving  in  season,  and  the  child  being  half -born 
at  some  time  before  I  arrived,  was  very  much  exposed 
to  the  cold  at  the  time  of  confinement,  and  afterwards, 
being  confined  in  a  very  open,  cold  room.  Of  the  six 
cases  you  perceive  only  one  recovered. 

"  In  the  winter  of  1817  two  of  my  patients  had  pu 
erperal  fever,  one  very  badly,  the  other  not  so  badly. 
Both  recovered.  One  other  had  swelled  leg,  or  phleg- 
masia  dolens,  and  one  or  two  others  did  not  recover  as 
well  as  usual. 

"  In  the  summer  of  1835  another  disastrous  period 
occurred  in  my  practice.  July  1st,  I  attended  a  lady 
in  labor,  who  was  afterwards  quite  ill  and  feverish  j 


THE   CONTAGIOUSNESS    OF   PUERPERAL   FEVER.     151 

but  at  the  time  I  did  not  consider  her  case  a  decided 
puerperal  fever.  On  the  8th,  I  attended  one  who  did 
well.  On  the  12th,  one  who  was  seriously  sick.  This 
was  also  an  equivocal  case,  apparently  arising  from 
constipation  and  irritation  of  the  rectum.  These 
women  were  ten  miles  apart  and  five  from  my  resi 
dence.  On  15th  and  20th,  two  who  did  well.  On 
25th,  I  attended  another.  This  was  a  severe  labor, 
and  followed  by  unequivocal  puerperal  fever,  or  peri 
tonitis.  She  recovered.  August  2d  and  3d,  in  about 
twenty-four  hours  I  attended  four  persons.  Two  of 
them  did  very  well ;  one  was  attacked  with  some  of 
the  common  symptoms,  which  however  subsided  in  a 
day  or  two,  and  the  other  had  decided  puerperal  fever, 
but  recovered.  This  woman  resided  five  miles  from 
me.  Up  to  this  time  I  wore  the  same  coat.  All  my 
other  clothes  had  frequently  been  changed.  On  6th,  I 
attended  two  women,  one  of  whom  was  not  sick  at  all ; 
but  the  other,  Mrs.  L.,  was  afterwards  taken  ill.  On 
10th,  I  attended  a  lady,  who  did  very  well.  I  had 
previously  changed  all  my  clothes,  and  had  no  gar 
ment  on  which  had  been  in  a  puerperal  room.  On  12th, 
I  was  called  to  Mrs.  S.,  in  labor.  While  she  was  ill, 
I  left  her  to  visit  Mrs.  L.,  one  of  the  ladies  who  was 
confined  on  6th.  Mrs.  L.  had  been  more  unwell  than 
usual,  but  I  had  not  considered  her  case  anything 
more  than  common  till  this  visit.  I  had  on  a  surtout 
at  this  visit,  which,  on  my  return  to  Mrs.  S.,  I  left  in 
another  room.  Mrs.  S.  was  delivered  on  13th  with 
forceps.  These  women  both  died  of  decided  puerperal 
fever. 

"  While  I  attended  these  women  in  their  fevers,  I 
changed  my  clothes,  and  washed  my  hands  in  a  solu 
tion  of  chloride  of  lime  after  each  visit.  I  attended 


152  MEDICAL  ESSAYS. 

seven  women  in  labor  during  this  period,  all  of  whom 
recovered  without  sickness. 

"  In  my  practice  I  have  had  several  single  cases  of 
puerperal  fever,  some  of  whom  have  died  and  some 
have  recovered.  Until  the  year  1830  I  had  no  sus 
picion  that  the  disease  could  be  communicated  from 
one  patient  to  another  by  a  nurse  or  midwife  ;  but  I  now 
think  the  foregoing  facts  strongly  favor  that  idea.  I 
was  so  much  convinced  of  this  fact,  that  I  adopted  the 
plan  before  related. 

"  I  believe  my  own  health  was  as  good  as  usual  at 
each  of  the  above  periods.  I  have  no  recollection  to 
the  contrary. 

"  I  believe  I  have  answered  all  your  questions.  I 
have  been  more  particular  on  some  points  perhaps  than 
necessary;  but  I  thought  you  could  form  your  own 
opinion  better  than  to  take  mine.  In  1830  I  wrote  to 
Dr.  Channing  a  more  particular  statement  of  my  cases. 
If  I  have  not  answered  your  questions  sufficiently, 
perhaps  Dr.  C.  may  have  my  letter  to  him,  and  you 
can  find  your  answer  there."  a 

"BOSTON,  February  3,  1843. 

HI.  "  MY  DEAR  SIR,  —  I  received  a  note  from  you 
last  evening,  requesting  me  to  answer  certain  questions 
therein  proposed,  touching  the  cases  of  puerperal  fever 
which  came  under  my  observation  the  past  summer. 
It  gives  me  pleasure  to  comply  with  your  request,  so 
far  as  it  is  in  my  power  so  to  do,  but,  owing  to  the 
hurry  in  preparing  for  a  journey,  the  notes  of  the 
cases  I  had  then  taken  were  lost  or  mislaid.  The  prin- 

•  In  a  letter  to  myself,  this  gentleman  also  stated,  "  I  do  not 
recollect  that  there  was  any  erysipelas  or  any  other  disease  par 
ticularly  prevalent  at  the  time." 


THE   CONTAGIOUSNESS   OF   PUERPERAL   FEVER.    158 

cipal  facts,  however,  are  too  vivid  upon  my  recollection 
to  be  soon  forgotten.  I  think,  therefore,  that  I  shall 
be  able  to  give  you  all  the  information  you  may  require. 

"All  the  cases  that  occurred  in  my  practice  took 
place  between  the  7th  of  May  and  the  17th  of  June 
1842. 

"  They  were  not  confined  to  any  particular  part  of 
the  city.  The  first  two  cases  were  patients  residing  at 
the  South  End,  the  next  was  at  the  extreme  North 
End,  one  living  in  Sea  Street  and  the  other  in  Rox- 
bury.  The  following  is  the  order  in  which  they  oc 
curred  :  — 

"  Case  1.  Mrs.  was  confined  on  the  7th  of 

May,  at  5  o'clock,  P.  M.,  after  a  natural  labor  of  six 
hours.  At  12  o'clock  at  night,  on  the  9th  (thirty-one 
hours  after  confinement),  she  was  taken  with  severe 
chill,  previous  to  which  she  was  as  comfortable  as 
women  usually  are  under  the  circumstances.  She  died 
on  the  10th. 

"Case  2.  Mrs.  was  confined  on  the  10th  of 

June  (four  weeks  after  Mrs.  C.),  at  11  A.  M.,  after  a 
natural,  but  somewhat  severe  labor  of  five  hours.  At 
7  o'clock,  on  the  morning  of  the  llth,  she  had  a  chill. 
Died  on  the  12th. 

"  Case  3.  Mrs. ,  confined  on  the  14th  of  June, 

was  comfortable  until  the  18th,  when  symptoms  of 
puerperal  fever  were  manifest.  She  died  on  the  20th. 

"Case  4.  Mrs.  ,  confined  June  17th,  at  5 

o'clock,  A.  M.,  was  doing  well  until  the  morning  of  the 
19th.  She  died  on  the  evening  of  the  21st. 

*'  Case  5.  Mrs.  was  confined  with  her  fifth 

child  on  the  17th  of  June,  at  6  o'clock  in  the  evening. 
This  patient  had  been  attacked  with  puerperal  fever, 
at  three  of  her  previous  confinements,  but  the  disease 


154  MEDICAL  ESSAYS. 

yielded  to  depletion  and  other  remedies  without  diffi. 
culty.  This  time,  I  regret  to  say,  I  was  not  so  fortu 
nate.  She  was  not  attacked,  as  were  the  other  patients, 
with  a  chill,  but  complained  of  extreme  pain  in  abdo 
men,  and  tenderness  on  pressure,  almost  from  the  mo 
ment  of  her  confinement.  In  this  as  in  the  other  cases, 
the  disease  resisted  all  remedies,  and  she  died  in  great 
distress  on  the  22d  of  the  same  month.  Owing  to 
the  extreme  heat  of  the  season,  and  my  own  indispo 
sition,  none  of  the  subjects  were  examined  after  death. 
Dr.  Channing,  who  was  in  attendance  with  me  on  the 
three  last  cases,  proposed  to  have  a  post-mortem  ex 
amination  of  the  subject  of  case  No.  5,  but  from  some 
cause  which  I  do  not  now  recollect  it  was  not  obtained. 

"  You  wish  to  know  whether  I  wore  the  same  clothes 
when  attending  the  different  cases.  I  cannot  positively 
say,  but  I  should  think  I  did  not,  as  the  weather 
became  warmer  after  the  first  two  cases ;  I  therefore 
think  it  probable  that  I  made  a  change  of  at  least  a 
part  of  my  dress.  I  have  had  no  other  case  of  puer 
peral  fever  in  my  own  practice  for  three  years,  save 
those  above  related,  and  I  do  not  remember  to  have 
lost  a  patient  before  with  this  disease.  While  absent, 
last  July,  I  visited  two  patients  sick  with  puerperal 
fever,  with  a  friend  of  mine  in  the  country.  Both  of 
them  recovered. 

"  The  cases  that  I  have  recorded  were  not  confined 
to  any  particular  constitution  or  temperament,  but  it 
seized  upon  the  strong  and  the  weak,  the  old  and  the 
young,  —  one  being  over  forty  years,  and  the  youngest 
under  eighteen  years  of  age.  ...  If  the  disease  is  of 
an  erysipelatous  nature,  as  many  suppose,  contagionists 
may  perhaps  find  some  ground  for  their  belief  in  the 
fact,  that,  for  two  weeks  previous  to  my  first  case  of 


THE  CONTAGIOUSNESS  OP  PUERPERAL  FEVER.  155 

puerperal  fever,  I  had  been  attending  a  severe  case  of 
erysipelas,  and  the  infection  may  have  been  conveyed 
through  me  to  the  patient ;  but,  on  the  other  hand,  why 
is  not  this  the  case  with  other  physicians,  or  with  the 
same  physician  at  all  times,  for  since  my  return  from 
the  country  I  have  had  a  more  inveterate  case  of  ery 
sipelas  than  ever  before,  and  no  difficulty  whatever  has 
attended  any  of  my  midwifery  cases  ?  " 

I  am  assured,  on  unquestionable  authority,  that 
"About  three  years  since,  a  gentleman  in  extensive 
midwifery  business,  in  a  neighboring  State,  lost  in  the 
course  of  a  few  weeks  eight  patients  in  child-bed,  seven 
of  them  being  undoubted  cases  of  puerperal  fever.  No 
other  physician  of  the  town  lost  a  single  patient  of  this 
disease  during  the  same  period."  And  from  what  I 
have  heard  in  conversation  with  some  of  our  most  ex 
perienced  practitioners,  I  am  inclined  to  think  many 
cases  of  the  kind  might  be  brought  to  light  by  exten 
sive  inquiry. 

This  long  catalogue  of  melancholy  histories  assumes 
a  still  darker  aspect  when  we  remember  how  kindly 
nature  deals  with  the  parturient  female,  when  she  is 
not  immersed  in  the  virulent  atmosphere  of  an  impure 
lying-in  hospital,  or  poisoned  in  her  chamber  by  the 
unsuspected  breath  of  contagion.  From  all  causes 
tog-ether,  not  more  than  four  deaths  in  a  thousand 

O  * 

births  and  miscarriages  happened  in  England  and 
Wales  during  the  period  embraced  by  the  first  Report 
of  the  Registrar-General."  In  the  second  Report  the 
mortality  was  shown  to  be  about  five  in  one  thousand.* 
In  the  Dublin  Lying-in  Hospital,  during  the  seven 
«  1st  Report,  p.  105.  *  2d  Report,  p.  73. 


156  MEDICAL  ESSAYS. 

years  of  Dr.  Collins's  mastership,  there  was  one  case 
of  puerperal  fever  to  178  deliveries,  or  less  than  six 
to  the  thousand,  and  one  death  from  this  disease  in 
278  cases,  or  between  three  and  four  to  the  thousand.0 
Yet  during  this  period  the  disease  was  endemic  in  the 
hospital,  and  might  have  gone  on  to  rival  the  horrors 
of  the  pestilence  of  the  Maternite",  had  not  the  poison 
been  destroyed  by  a  thorough  purification. 

In  private  practice,  leaving  out  of  view  the  cases 
that  are  to  be  ascribed  to  the  self-acting  system  of  prop 
agation,  it  would  seem  that  the  disease  must  be  far 
from  common.  Mr.  White  of  Manchester  says,  "  Out 
of  the  whole  number  of  lying-in  patients  whom  I  have 
delivered  (and  I  may  safely  call  it  a  great  one),  I 
have  never  lost  one,  nor  to  the  best  of  my  recollection 
has  one  been  greatly  endangered,  by  the  puerperal, 
miliary,  low  nervous,  putrid  malignant,  or  milk  fever."  * 
Dr.  Joseph  Clarke  informed  Dr.  Collins,  that  in  the 
course  of  forty-five  years'  most  extensive  practice  he 
lost  but  four  patients  from  this  disease.6  One  of  the 
most  eminent  practitioners  of  Glasgow,  who  has  been 
engaged  in  very  extensive  practice  for  upwards  of  a 
quarter  of  a  century,  testifies  that  he  never  saw  more 
than  twelve  cases  of  real  puerperal  fever.*1 

I  have  myself  been  told  by  two  gentlemen  practising 
in  this  city,  and  having  for  many  years  a  large  mid 
wifery  business,  that  they  had  neither  of  them  lost  a 
patient  from  this  disease,  and  by  one  of  them  that  he 
had  only  seen  it  in  consultation  with  other  physicians. 
In  five  hundred  cases  of  midwifery,  of  which  Dr.  Storer 

•  Collins's  Treatise  on  Midwifery,  p.  228,  etc. 

»  Op.  cit.   p.  115. 

«  Op.  cit.  p.  228. 

<*  Lancet,  May  4,  1833. 


THE  CONTAGIOUSNESS   OP  PUEEPERAL  FEVER.   157 

has  given  an  abstract  in  the  first  number  of  this  Journal, 
there  was  only  one  instance  of  fatal  puerperal  peritonitis. 

In  the  view  of  these  facts,  it  does  appear  a  singular 
coincidence,  that  one  man  or  woman  should  have  ten, 
twenty,  thirty,  or  seventy  cases  of  this  rare  disease  fol 
lowing  his  or  her  footsteps  with  the  keenness  of  a 
beagle,  through  the  streets  and  lanes  of  a  crowded  city, 
while  the  scores  that  cross  the  same  paths  on  the  same 
errands  know  it  only  by  name.  It  is  a  series  of  simi 
lar  coincidences  which  has  led  us  to  consider  the  dag 
ger,  the  musket,  and  certain  innocent-looking  white 
powders  as  having  some  little  claim  to  be  regarded  as 
dangerous.  It  is  the  practical  inattention  to  similar 
coincidences  which  has  given  rise  to  the  unpleasant  but 
often  necessary  documents  called  indictments,  which 
has  sharpened  a  form  of  the  cephalotome  sometimes 
employed  in  the  case  of  adults,  and  adjusted  that  modi 
fication  of  the  fillet  which  delivers  the  world  of  those 
who  happen  to  be  too  much  in  the  way  while  such 
striking  coincidences  are  taking  place. 

I  shall  now  mention  a  few  instances  in  which  the 
disease  appears  to  have  been  conveyed  by  the  process 
of  direct  inoculation. 

Dr.  Campbell  of  Edinburgh  states  that  in  October, 
1821,  he  assisted  at  the  post-mortem  examination  of  a 
patient  who  died  with  puerperal  fever.  He  carried  the 
pelvic  viscera  in  his  pocket  to  the  class-room.  The 
same  evening  he  attended  a  woman  in  labor  without 
previously  changing  his  clothes;  this  patient  died. 
The  next  morning  he  delivered  a  woman  with  the  for 
ceps  ;  she  died  also,  and  of  many  others  who  were 
seized  with  the  disease  within  a  few  weeks,  three  shared 
the  same  fate  in  succession. 

In  June,  1823,  he  assisted  some  of  his  pupils  at  the 


158  MEDICAL  ESSAYS. 

autopsy  of  a  case  of  puerperal  fever.  He  was  unable 
to  wash  his  hands  with  proper  care,  for  want  of  the 
necessary  accommodations.  On  getting  home  he  found 
that  two  patients  required  his  assistance.  He  went 
without  further  ablution,  or  changing  his  clothes ;  both 
these  patients  died  with  puerperal  fever.a  This  same 
Dr.  Campbell  is  one  of  Dr.  Churchill's  authorities 
against  contagion. 

Mr.  Roberton  says  that  in  one  instance  within  his 
knowledge  a  practitioner  passed  the  catheter  for  a 
patient  with  puerperal  fever  late  in  the  evening ;  the 
same  night  he  attended  a  lady  who  had  the  symptoms 
of  the  disease  on  the  second  day.  In  another  instance 
a  surgeon  was  called  while  in  the  act  of  inspecting  the 
body  of  a  woman  who  had  died  of  this  fever,  to  attend 
a  labor ;  within  forty-eight  hours  this  patient  was  seized 
with  the  fever.6 

On  the  16th  of  March,  1831,  a  medical  practitioner 
examined  the  body  of  a  woman  who  had  died  a  few 
days  after  delivery,  from  puerperal  peritonitis.  On 
the  evening  of  the  17th  he  delivered  a  patient,  who  was 
seized  with  puerperal  fever  on  the  19th,  and  died  on 
the  24th.  Between  this  period  and  the  6th  of  April, 
the  same  practitioner  attended  two  other  patients,  both 
of  whom  were  attacked  with  the  same  disease  and 
died.6 

In  the  autumn  of  1829  a  physician  was  present  at 
the  examination  of  a  case  of  puerperal  fever,  dissected 
out  the  organs,  and  assisted  in  sewing  up  the  body. 
He  had  scarcely  reached  home  when  he  was  summoned 
to  attend  a  young  lady  in  labor.  In  sixteen  hours  she 

•  Lond.Med.  Gazette,  December  10,  1831. 
1  Ibid,  for  January,  1832. 

•  London  Cyc.  of  Pract.  Med.  art.  "  Fever,  Puerperal." 


THE  CONTAGIOUSNESS   OF  PUERPERAL  FEVER.    159 

was  attacked  with  the  symptoms  of  puerperal  fever, 
and  narrowly  escaped  with  her  life." 

In  December,  1830,  a  midwife,  who  had  attended  two 
fatal  cases  of  puerperal  fever  at  the  British  Lying-in 
Hospital,  examined  a  patient  who  had  just  been  ad 
mitted,  to  ascertain  if  labor  had  commenced.  This 
patient  remained  two  days  in  the  expectation  that  labor 
would  come  on,  when  she  returned  home  and  was  then 
suddenly  taken  in  labor  and  delivered  before  she  could 
set  out  for  the  hospital.  She  went  on  favorably  for 
two  days,  and  was  then  taken  with  puerperal  fever  and 
died  in  thirty-six  hours.* 

"  A  young  practitioner,  contrary  to  advice,  examined 
the  body  of  a  patient  who  had  died  from  puerperal 
fever;  there  was  no  epidemic  at  the  time;  the  case 
appeared  to  be  purely  sporadic.  He  delivered  three 
other  women  shortly  afterwards ;  they  all  died  with 
puerperal  fever,  the  symptoms  of  which  broke  out  very 
soon  after  labor.  The  patients  of  his  colleague  did 
well,  except  one,  where  he  assisted  to  remove  some  co- 
agula  from  the  uterus ;  she  was  attacked  in  the  same 
manner  as  those  whom  he  had  attended,  and  died  also." 
The  writer  in  the  "  British  and  Foreign  Medical  Re 
view,"  from  whom  I  quote  this  statement,  —  and  who 
is  no  other  than  Dr.  Rigby,  —  adds,  "  We  trust  that 
this  fact  alone  will  forever  silence  such  doubts,  and 
stamp  the  well-merited  epithet  of  '  criminal,'  as  above 
quoted,  upon  such  attempts."  * 

From  the  cases  given  by  Mr.  Ingleby,  I  select  the 
following.  Two  gentlemen,  after  having  been  engaged 
in  conducting  the  postmortem  examination  of  a  case  of 

•  London  Cyc.  of  Pract.  Med.  art.  "  Fever,  Puerperal." 

•  Ibid. 

•  Brit,  and  For.  Medical  Review  for  Jan.  1842,  p.  112. 


160  MEDICAL  ESSAYS. 

puerperal  fever,  went  in  the  same  dress,  each  respect 
ively,  to  a  case  of  midwifery.  "  The  one  patient  was 
seized  with  the  rigor  about  thirty  hours  afterwards. 
The  other  patient  was  seized  with  a  rigor  the  third 
morning  after  delivery.  One  recovered,  one  died."  * 
One  of  these  same  gentlemen  attended  another  woman 
in  the  same  clothes  two  days  after  the  autopsy  referred 
to.  "  The  rigor  did  not  take  place  until  the  evening 
of  the  fifth  day  from  the  first  visit.  Result  fatal" 
These  cases  belonged  to  a  series  of  seven,  the  first  of 
which  was  thought  to  have  originated  in  a  case  of  ery 
sipelas.  "  Several  cases  of  a  mild  character  followed 
the  foregoing  seven,  and  their  nature  being  now  most 
unequivocal,  my  friend  declined  visiting  all  midwifery 
cases  for  a  time,  and  there  was  no  recurrence  of  the 
disease."  These  cases  occurred  in  1833.  Five  of  them 
proved  fatal.  Mr.  Ingleby  gives  another  series  of  seven 
cases  which  occurred  to  a  practitioner  in  1836,  the  first 
of  which  was  also  attributed  to  his  having  opened  sev 
eral  erysipelatous  abscesses  a  short  time  previously. 

I  need  not  refer  to  the  case  lately  read  before  this 
Society,  in  which  a  physician  went,  soon  after  perform 
ing  an  autopsy  of  a  case  of  puerperal  fever,  to  a  woman 
in  labor,  who  was  seized  with  the  same  disease  and  per 
ished.  The  forfeit  of  that  error  has  been  already  paid. 

At  a  meeting  of  the  Medical  and  Chirurgical  Society 
before  referred  to,  Dr.  Merriman  related  an  instance  oc 
curring  in  his  own  practice,  which  excites  a  reasonable 
suspicion  that  two  lives  were  sacrificed  to  a  still  less 
dangerous  experiment.  He  was  at  the  examination  of 
a  case  of  puerperal  fever  at  two  o'clock  in  the  after 
noon.  He  took  care  not  to  touch,  the  body.  At  nine 
o'clock  the  same  evening  he  attended  a  woman  in  la- 

•  Edin.  Med.  and  Surg.  Journal,  April,  1838. 


THE  CONTAGIOUSNESS  OF  PUERPERAL  FEVER.  161 

bor ;  she  was  so  nearly  delivered  that  he  had  scarcely 
anything  to  do.  The  next  morning  she  had  severe 
rigors,  and  in  forty-eight  hours  she  was  a  corpse.  Her 
infant  had  erysipelas  and  died  in  two  days." 

In  connection  with  the  facts  which  have  been  stated, 
it  seems  proper  to  allude  to  the  dangerous  and  often 
fatal  effects  which  have  followed  from  wounds  received 
in  the  post-mortem  examination  of  patients  who  have 
died  of  puerperal  fever.  The  fact  that  such  wounds 
are  attended  with  peculiar  risk  has  been  long  noticed. 
I  find  that  Chaussier  was  in  the  habit  of  cautioning 
his  students  against  the  danger  to  which  they  were  ex 
posed  in  these  dissections.6  The  head  pharmacien  of 
the  HOtel  Dieu,  in  his  analysis  of  the  fluid  effused  in 
puerperal  peritonitis,  says  that  practitioners  are  con 
vinced  of  its  deleterious  qualities,  and  that  it  is  very 
dangerous  to  apply  it  to  the  denuded  skin.c  Sir  Ben 
jamin  Brodie  speaks  of  it  as  being  well  known  that 
the  inoculation  of  lymph  or  pus  from  the  peritoneum 
of  a  puerperal  patient  is  often  attended  with  danger 
ous  and  even  fatal  symptoms.  Three  cases  in  confir 
mation  of  this  statement,  two  of  them  fatal,  have  been 
reported  to  this  Society  within  a  few  months. 

Of  about  fifty  cases  of  injuries  of  this  kind,  of  various 
degrees  of  severity,  which  I  have  collected  from  differ 
ent  sources,  at  least  twelve  were  instances  of  infection 
from  puerperal  peritonitis.  Some  of  the  others  are  so 
stated  as  to  render  it  probable  that  they  may  have 
been  of  the  same  nature.  Five  other  cases  were  of 
peritoneal  inflammation ;  three  in  males.  Three  were 

*  Lancet,  May  2,  1840. 

*  Stein,  L1  Art  d'Accoucher,  1794  ;  Diet,  des  Sciences  Medif 
tales,  art.  "Puerperal." 

*  Journal  de  Pharmacie,  January,  1836. 


162  MEDICAL  ESSAYS. 

what  was  called  enteritis,  in  one  instance  complicated 
with  erysipelas ;  but  it  is  well  known  that  this  term  has 
been  often  used  to  signify  inflammation  of  the  perito 
neum  covering  the  intestines.  On  the  other  hand,  no 
case  of  typhus  or  typhoid  fever  is  mentioned  as  giving 
rise  to  dangerous  consequences,  with  the  exception  of 
the  single  instance  of  an  undertaker  mentioned  by 
Mr.  Travers,  who  seems  to  have  been  poisoned  by  a 
fluid  which  exuded  from  the  body.  The  other  acci 
dents  were  produced  by  dissection,  or  some  other  mode 
of  contact  with  bodies  of  patients  who  had  died  of  va 
rious  affections.  They  also  differed  much  in  severity, 
the  cases  of  puerperal  origin  being  among  the  most 
formidable  and  fatal.  Now  a  moment's  reflection  will 
show  that  the  number  of  cases  of  serious  consequences 
ensuing  from  the  dissection  of  the  bodies  of  those  who 
had  perished  of  puerperal  fever  is  so  vastly  dispro- 
portioned  to  the  relatively  small  number  of  autopsies 
made  in  this  complaint  as  compared  with  typhus  or 
pneumonia  (from  which  last  disease  not  one  case  of 
poisoning  happened),  and  still  more  from  all  diseases 
put  together,  that  the  conclusion  is  irresistible  that  a 
most  fearful  morbid  poison  is  often  generated  in  the 
course  of  this  disease.  Whether  or  not  it  is  sui  gen 
eris,  confined  to  this  disease,  or  produced  in  some 
others,  as,  for  instance,  erysipelas,  I  need  not  stop  to 
inquire. 

In  connection  with  this  may  be  taken  the  following 
statement  of  Dr.  Kigby.  "  That  the  discharges  from 
a  patient  under  puerperal  fever  are  in  the  highest  de 
gree  contagious  we  have  abundant  evidence  in  the  his 
tory  of  lying-in  hospitals.  The  puerperal  abscesses  are 
also  contagious,  and  may  be  communicated  to  healthy 
lying-in  women  by  washing  with  the  same  sponge ;  this 


THE  CONTAGIOUSNESS  OF  PUERPERAL  FEVER.  163 

fact  has  been  repeatedly  proved  in  the  Vienna  Hos» 
pital;  but  they  are  equally  communicable  to  women 
not  pregnant ;  on  more  than  one  occasion  the  women 
engaged  in  washing  the  soiled  bed-linen  of  the  General 
Lying-in  Hospital  have  been  attacked  with  abscess  in 
the  fingers  or  hands,  attended  with  rapidly  spreading 
inflammation  of  the  cellular  tissue."  a 

Now  add  to  all  this  the  undisputed  fact,  that  within 
the  walls  of  lying-in  hospitals  there  is  often  generated 
a  miasm,  palpable  as  the  chlorine  used  to  destroy  it, 
tenacious  so  as  in  some  cases  almost  to  defy  extirpa 
tion,  deadly  in  some  institutions  as  the  plague ;  which 
has  killed  women  in  a  private  hospital  of  London  so 
fast  that  they  were  buried  two  in  one  coffin  to  conceal 
its  horrors ;  which  enabled  Tonnelle  to  record  two 
hundred  and  twenty-two  autopsies  at  the  Maternite  of 
Paris ;  which  has  led  Dr.  Lee  to  express  his  deliber 
ate  conviction  that  the  loss  of  life  occasioned  by  these 
institutions  completely  defeats  the  objects  of  their  found 
ers  ;  and  out  of  this  train  of  cumulative  evidence,  the 
multiplied  groups  of  cases  clustering  about  individuals, 
the  deadly  results  of  autopsies,  the  inoculation  by 
fluids  from  the  living  patient,  the  murderous  poison  of 
hospitals,  —  does  there  not  result  a  conclusion  that 
laughs  all  sophistry  to  scorn,  and  renders  all  argument 
an  insult  ? 

I  have  had  occasion  to  mention  some  instances  in 
which  there  was  an  apparent  relation  between  puer 
peral  fever  and  erysipelas.  The  length  to  which  this 
paper  has  extended  does  not  allow  me  to  enter  into  the 
consideration  of  this  most  important  subject.  I  will 
only  say,  that  the  evidence  appears  to  me  altogether 
satisfactory  that  some  most  fatal  series  of  puerperal 
•  System  of  Midwifery,  p.  292. 


164  MEDICAL  ESSAYS. 

fever  have  been  produced  by  an  infection  originating 
in  the  matter  or  effluvia  of  erysipelas.  In  evidence  of 
some  connection  between  the  two  diseases,  I  need  not 
go  back  to  the  older  authors,  as  Pouteau  or  Gordon, 
but  will  content  myself  with  giving  the  following  refer 
ences,  with  their  dates;  from  which  it  will  be  seen 
that  the  testimony  has  been  constantly  coming  before 
the  profession  for  the  last  few  years. 

tk  London  Cyclopaedia  of  Practical  Medicine,"  article 
Puerperal  Fever,  1833. 

Mr.  Ceeley's  Account  of  the  Puerperal  Fever  at 
Aylesbury.  "  Lancet,"  1835. 

Dr.  Ramsbotham's  Lecture.  "  London  Medical  Ga 
zette,"  1835. 

Mr.  Yates  Ackerly's  Letter  in  the  same  Journal, 
1838. 

Mr.  Ingleby  on  Epidemic  Puerperal  Fever.  "  Edin 
burgh  Medical  and  Surgical  Journal,"  1838. 

Mr.  Paley's  Letter.  "London  Medical  Gazette," 
1839. 

Remarks  at  the  Medical  and  Chirurgical  Society. 
"  Lancet,"  1840. 

Dr.  Rigby's  "  System  of  Midwifery."     1841. 

"  Nunneley  on  Erysipelas," —  a  work  which  contains 
a  large  number  of  references  on  the  subject.  1841. 

"  British  and  Foreign  Quarterly  Review,"  1842. 

Dr.  S.  Jackson  of  Northumberland,  as  already  quoted 
from  the  Summary  of  the  College  of  Physicians,  1842. 

And  lastly,  a  startling  series  of  cases  by  Mr.  Storrs 
of  Doncaster,  to  be  found  in  the  "  American  Journal 
of  the  Medical  Sciences  "  for  January,  1843. 

The  relation  of  puerperal  fever  with  other  continued 
fevers  would  seem  to  be  remote  and  rarely  obvious. 
Hey  refers  to  two  cases  of  synochus  occurring  in  the 


THE  CONTAGIOUSNESS  OF  PUERPERAL  FEVER.  165 

Royal  Infirmary  of  Edinburgh,  in  women  who  had  at 
tended  upon  puerperal  patients.  Dr.  Collins  refers  to 
several  instances  in  which  puerperal  fever  has  appeared 
to  originate  from  a  continued  proximity  to  patients 
suffering  with  typhus." 

Such  occurrences  as  those  just  mentioned,  though 
most  important  to  be  remembered  and  guarded  against, 
hardly  attract  our  notice  in  the  midst  of  the  gloomy 
facts  by  which  they  are  surrounded.  Of  these  facts, 
at  the  risk  of  fatiguing  repetitions,  I  have  summoned 
a  sufficient  number,  as  I  believe,  to  convince  the  most 
incredulous  that  every  attempt  to  disguise  the  truth 
which  underlies  them  all  is  useless. 

It  is  true  that  some  of  the  historians  of  the  disease, 
especially  Hulme,  Hull,  and  Leake,  in  England  ;  Ton- 
nelle*,  Duges,  and  Baudelocque,  in  France,  profess  not 
to  have  found  puerperal  fever  contagious.  At  the  most 
they  give  us  mere  negative  facts,  worthless  against  an 
extent  of  evidence  which  now  overlaps  the  widest  range 
of  doubt,  and  doubles  upon  itself  in  the  redundancy 
of  superfluous  demonstration.  Examined  in  detail, 
this  and  much  of  the  show  of  testimony  brought  up  to 
stare  the  daylight  of  conviction  out  of  countenance, 
proves  to  be  in  a  great  measure  unmeaning  and  inap 
plicable,  as  might  be  easily  shown  were  it  necessary. 
Nor  do  I  feel  the  necessity  of  enforcing  the  conclusion 
which  arises  spontaneously  from  the  facts  which  have 
been  enumerated,  by  formally  citing  the  opinions  of 
those  grave  authorities  who  have  for  the  last  half-cen 
tury  been  sounding  the  unwelcome  truth  it  has  cost  so 
many  lives  to  establish. 

"  It  is  to  the  British  practitioner,"  says  Dr.  Rigby, 
¥that  we  are  indebted  for  strongly  insisting  upon 
"  Treatise  on  Midwifery,  p.  228. 


166  MEDICAL  ESSAYS. 

this  important  and  dangerous  character  of  puerperal 
fever."  a 

The  names  of  Gordon,  John  Clarke,  Denman,  Burns, 
Young,6  Hamilton,0  Haighton,*  Good,"  Waller/  Blun- 
dell,  Gooch,  Ramsbotham,  Douglas,"  Lee,  Ingleby, 
Locock,A  Abercrombie,*  Alison/  Travers,*  Rigby,  and 
Watson,'  many  of  whose  writings  I  have  already  re 
ferred  to,  may  have  some  influence  with  those  who  pre 
fer  the  weight  of  authorities  to  the  simple  deductions 
of  their  own  reason  from  the  facts  laid  before  them. 
A  few  Continental  writers  have  adopted  similar  con- 
clusions.m  It  gives  me  pleasure  to  remember,  that 
while  the  doctrine  has  been  unceremoniously  discred 
ited  in  one  of  the  leading  Journals,"  and  made  very 
light  of  by  teachers  in  two  of  the  principal  Medical 
Schools,  of  this  country,  Dr.  Channing  has  for  many 
years  inculcated,  and  enforced  by  examples,  the  danger 
to  be  apprehended  and  the  precautions  to  be  taken  in 
the  disease  under  consideration. 

I  have  no  wish  to  express  any  harsh  feeling  with  re- 

a  British  and  Foreign  Med.  Rev.  for  January,  1842. 
b  Encyc.  Britannica,  xiii.  467,  art.  "Medicine." 
c  Outlines  of  Midwifery,  p.  109. 
d  Oral  Lectures,  etc. 

*  Study  of  Medicine,  ii.  195. 

f  Medical  and  Physical  Journal,  July,  1830. 
'  Dublin  Hospital  Reports  for  1822. 

*  Library  of  Practical  Medicine,  i.  373. 

*  Researches  on  Diseases  of  the  Stomach,  etc.  p.  181. 
J  Library  of  Practical  Medicine,  i.  96. 

*  Further  Researches  on  Constitutional  Irritation,  p.  128. 
1  London  Medical  Gazette,  February,  1842. 

m  See  British  and  Foreign  Medical  Review,  vol.  iii.  p.  525,  and 
vol.  iv.  p.  517.  Also  Ed.  Med.  and  Surg.  Journal  for  July,  1824} 
ftnd  American  Journal  of  Med.  Sciences  for  January,  1841. 

*  Phil.  Med.  Journal,  vol.  xii.  p.  364. 


THE   CONTAGIOUSNESS  OF  PUERPERAL  FEVER.    167 

gard  to  the  painful  subject  which  has  come  before  us. 
If  there  are  any  so  far  excited  by  the  story  of  these 
dreadful  events  that  they  ask  for  some  word  of  indig 
nant  remonstrance  to  show  that  science  does  not  turn 
the  hearts  of  its  followers  into  ice  or  stone,  let  me  re 
mind  them  that  such  words  have  been  uttered  by  those 
who  speak  with  an  authority  I  could  not  claim."  It  is 
as  a  lesson  rather  than  as  a  reproach  that  I  call  up  the 
memory  of  these  irreparable  errors  and  wrongs.  No 
tongue  can  tell  the  heart-breaking  calamity  they  have 
caused ;  they  have  closed  the  eyes  just  opened  upon  a 
new  world  of  love  and  happiness ;  they  have  bowed 
the  strength  of  manhood  into  the  dust ;  they  have  cast 
the  helplessness  of  infancy  into  the  stranger's  arms,  or 
bequeathed  it,  with  less  cruelty,  the  death  of  its  dying 
parent.  There  is  no  tone  deep  enough  for  regret,  and 
no  voice  loud  enough  for  warning.  The  woman  about 
to  become  a  mother,  or  with  her  new-born  infant  upon 
her  bosom,  should  be  the  object  of  trembling  care  and 
sympathy  wherever  she  bears  her  tender  burden,  or 
stretches  her  aching  limbs.  The  very  outcast  of  the 
streets  has  pity  upon  her  sister  in  degradation,  when 
the  seal  of  promised  maternity  is  impressed  upon  her. 
The  remorseless  vengeance  of  the  law,  brought  down 
upon  its  victim  by  a  machinery  as  sure  as  destiny,  is 
arrested  in  its  fall  at  a  word  which  reveals  her  tran 
sient  claim  for  mercy.  The  solemn  prayer  of  the  lit 
urgy  singles  out  her  sorrows  from  the  multiplied  trials 
of  life,  to  plead  for  her  in  the  hour  of  peril.  God 
forbid  that  any  member  of  the  profession  to  which  she 
trusts  her  life,  doubly  precious  at  that  eventful  period, 
should  hazard  it  negligently,  unadvisedly,  or  selfishly ! 
There  may  be  some  among  those  whom  I  address 

•  Dr.  Blundell  and  Dr.  Rigby  in  the  works  already  cited. 


168  MEDICAL  ESSAYS. 

who  are  disposed  to  ask  the  question,  What  course  are 
we  to  follow  in  relation  to  this  matter  ?  The  facts  are 
before  them,  and  the  answer  must  be  left  to  -their  own 
judgment  and  conscience.  If  any  should  care  to  know 
my  own  conclusions,  they  are  the  following;  and  in 
taking  the  liberty  to  state  them  very  freely  and  broad 
ly,  I  would  ask  the  inquirer  to  examine  them  as  freely 
in  the  light  of  the  evidence  which  has  been  laid  be 
fore  him. 

1.  A  physician  holding  himself  in  readiness  to  at 
tend  cases  of  midwifery  should  never  take  any  active 
part  in  the  post-mortem  examination  of  cases  of  puer 
peral  fever. 

2.  If  a  physician  is  present  at  such  autopsies,  he 
should  use  thorough  ablution,  change  every  article  of 
dress,  and  allow  twenty-four  hours  or  more  to  elapse 
before  attending  to  any  case  of  midwifery.     It  may  be 
well  to  extend  the  same  caution  to  cases  of  simple  per 
itonitis. 

3.  Similar  precautions   should   be  taken  after  the 
autopsy  or  surgical  treatment  of  cases  of  erysipelas, 
if  the  physician  is  obliged  to  unite  such  offices  with 
his  obstetrical  duties,  which  is  in  the  highest  degree 
inexpedient. 

4.  On  the  occurrence  of  a  single  case  of  puerperal 
fever  in  his  practice,  the  physician  is  bound  to  consider 
the  next  female  he  attends  in  labor,  unless  some  weeks 
at  least  have  elapsed,  as  in  danger  of  being  infected 
by  him,  and  it  is  his  duty  to  take  every  precaution  to 
diminish  her  risk  of  disease  and  death. 

5.  If  within  a  short  period  two  cases  of  puerperal 
fever  happen  close  to  each  other,  in  the  practice  of  the 
same  physician,  the  disease  not  existing  or  prevailing 
in  the  neighborhood,  he  would  do  wisely  to  relinquish 


THE   CONTAGIOUSNESS   OF   PUERPERAL   FEVER.    169 

his  obstetrical  practice  for  at  least  one  month,  and 
endeavor  to  free  himself  by  every  available  means 
from  any  noxious  influence  he  may  carry  about  with 
him. 

6.  The   occurrence  of  three  or  more   closely  con 
nected  cases,  in  the  practice  of  one  individual,  no  oth 
ers  existing  in  the  neighborhood,  and  no  other  suffi 
cient  cause  being  alleged  for  the  coincidence,  is  primd 
facie  evidence  that  he  is  the  vehicle  of  contagion. 

7.  It  is  the  duty  of  the  physician  to  take  every  pre 
caution  that  the  disease  shall  not  be  introduced  by 
nurses  or  other  assistants,  by  making  proper  inquiries 
concerning  them,  and  giving  timely  warning  of  every 
suspected  source  of  danger. 

8.  Whatever  indulgence  may  be  granted  to  those 
who  have  heretofore  been  the  ignorant  causes  of  so 
much  misery,  the  time  has  come  when  the  existence  of 
a  private  pestilence  in  the  sphere  of  a  single  physician 
should  be  looked  upon,  not  as  a  misfortune,  but  a 
crime ;  and  in  the  knowledge  of  such  occurrences  the 
duties  of  the  practitioner  to  his  profession  should  give 
way  to  his  paramount  obligations  to  society. 

ADDITIONAL    REFERENCES    AND    CASES. 

Fifth  Annual  Report  of  the  Registrar-General  of  England, 

1843.  Appendix.    Letter  from  William  Fair,  Esq.  —  Several 
new  series  of  cases  are  given  in  the  Letter  of  Mr.  Storrs,  con 
tained  in  the  Appendix  to  this  Report.     Mr.  Storrs  suggests 
precautions  similar  to  those  I  have  laid  down,  and  these  pre 
cautions  are  strongly  enforced  by  Mr.  Farr,  who  is,  therefore, 
obnoxious  to  the  same  criticisms  as  myself. 

Hall  and  Dexter,  in  Am.  Journal  of  Med.  Sc.  for  January, 

1844.  —  Cases  of  puerperal  fever  seeming  to  originate  in  erysip 
elas. 

Elkington,  of  Birmingham,  in  Provincial  Med.  Journal,  cited 


170  MEDICAL  ESSAYS. 

in  Am.  Journ.  Med.  Sc.  for  April,  1844. —  Six  cases  in  less  than 
a  fortnight,  seeming  to  originate  in  a  case  of  erysipelas. 

West's  Reports,  in  Brit,  and  For.  Med.  Review  for  October, 

1845,  and  January,  1847. —  Affection  of  the  arm,  resembling 
malignant  pustule,  after  removing  the  placenta  of  a  patient  who 
died  from  puerperal  fever.     Reference  to  cases  at  Wiirzburg, 
as  proving   contagion,  and  to  Keiller's  cases  in  the  Monthly 
Journal  for  February,  1846,  as  showing  connection  of  puerperal 
fever  and  erysipelas. 

Kneeland.  —  Contagiousness  of  Puerperal  Fever.  Am.  Jour. 
Med.  Sc.,  January,  1846.  Also,  Connection  between  Puerperal 
Fever  and  Epidemic  Erysipelas.  Ibid.,  April,  1846. 

Robert  Storrs.  —  Contagious  Effects  of  Puerperal  Fever  on  the 
Male  Subject;  or  on  Persons  not  Child-bearing.  (From  Pro 
vincial  Med.  and  Surg.  Journal.)  Am.  Jour.  Med.  Sc.,  January, 

1846.  Numerous  cases.    See  also  Dr.  Reid's  case  in  same  Jour 
nal  for  April,  1846. 

Roulh's  paper  in  Proc.  of  Royal  Med.  Chir.  Soc.,  Am.  Jour. 
Med.  Sc.,  April,  1849,  also  in  B.  and  F.  Med.  Chir.  Review, 
April,  1850. 

Hill,  of  Leitchars.  —  A  Series  of  Cases  illustrating  the  Conta 
gious  Nature  of  Erysipelas  and  of  Puerperal  Fever,  and  their 
Intimate  Pathological  Connection.  (From  Monthly  Journal  of 
Med.  Sc.)  Am.  Jour.  Med.  Sc.,  July,  1850. 

Skoda  on  the  Causes  of  Puerperal  Fever.  (Peritonitis  in  rab 
bits,  from  inoculation  with  different  morbid  secretions.)  Am. 
Jour.  Med.  Sc.,  October,  1850. 

Arneih.  —  Paper  read  before  the  National  Academy  of  Medi 
cine.  Annales  d'Hygiene,  Tome  LXV.  2*  Partie.  (Means  of 
Disinfection  proposed  by  M.  "  Semmeliveis  "  (Semmelweiss.) 
Lotions  of  chloride  of  lime  and  use  of  nail-brush  before  admis 
sion  to  lying-in  wards.  Alleged  sudden  and  great  decrease  of 
mortality  from  puerperal  fever.  Cause  of  disease  attributed  to. 
inoculation  with  cadaveric  matters.)  See  also  Routh's  paper, 
mentioned  above. 

Moir.  —  Remarks  at  a  meeting  of  the  Edinburgh  Medico-Chi- 
rurgical  Society.  Refers  to  cases  of  Dr.  Kellie,  of  Leith.  Six 
teen  in  succession,  all  fatal.  Also  to  several  instances  of 
individual  pupils  having  had  a  succession  of  cases  in  various 
quarters  of  the  town,  while  others,  practising  as  extensively  in 
the  same  localities,  had  none.  Abo  to  several  special  cases  not 


THE  CONTAGIOUSNESS  OF  PUERPERAL  FEVER.  171 

mentioned  elsewhere.  Am.  Jour.  Med.  Sc.  for  October,  1851. 
(From  New  Monthly  Journal  of  Med.  Science.) 

Simpson.  —  Observations  at  a  Meeting  of  the  Edinburgh  Ob 
stetrical  Society.  (An  "eminent  gentleman,"  according  to  Dr. 
Meigs,  whose  "  name  is  as  well  known  in  America  as  in  (his) 
native  land."  Obstetrics.  Phil.  1852,  pp.  368,  375.)  The  stu 
dent  is  referred  to  this  paper  for  a  valuable  resume  of  many  of 
the  facts,  and  the  necessary  inferences,  relating  to  this  subject. 
Also  for  another  series  of  cases,  Mr.  Sidey's,  five  or  six  in  rapid 
succession.  Dr.  Simpson  attended  the  dissection  of  two  of  Dr. 
Sidey's  cases,  and  freely  handled  the  diseased  parts.  His  next 
four  child-bed  patients  were  affected  with  puerperal  fever,  and 
it  was  the  first  time  he  had  seen  it  in  practice.  As  Dr.  Simpson 
is  a  gentleman  (Dr.  Meigs,  as  above),  and  as  "  a  gentleman's 
hands  are  clean  "  (Dr.  Meigs'  Sixth  Letter),  it  follows  that  a 
gentleman  with  clean  hands  may  carry  the  disease.  Am.  Jour. 
Med.  Sc.,  October,  1851. 

Peddie.  — The  five  or  six  cases  of  Dr.  Sidey,  followed  by  the 
four  of  Dr.  Simpson,  did  not  end  the  series.  A  practitioner  in 
Leith  having  examined  in  Dr.  Simpson's  house,  a  portion  of  the 
uterus  obtained  from  one  of  the  patients,  had  immediately  after 
wards  three  fatal  cases  of  puerperal  fever.  Dr.  Peddie  referred 
to  two  distinct  series  of  consecutive  cases  in  his  own  practice. 
He  had  since  taken  precautions,  and  not  met  with  any  such 
cases.  Am.  Jour.  Med.  Sc.,  October,  1851. 

Copland.  —  Considers  it  proved  that  puerperal  fever  may  be 
propagated  by  the  hands  and  the  clothes,  or  either,  of  a  third 
person,  the  bed-clothes  or  body-clothes  of  a  patient.  Mentions 
a  new  series  of  cases,  one  of  which  he  saw,  with  the  practitioner 
who  had  attended  them.  She  was  the  sixth  he  had  had  within 
a  few  days.  All  died.  Dr.  Copland  insisted  that  contagion  had 
caused  these  cases  ;  advised  precautionary  measures,  and  the 
practitioner  had  no  other  cases  for  a  considerable  time.  Con 
siders  it  criminal,  after  the  evidence  adduced,  —  which  he  could 
have  quadrupled,  —  and  the  weight  of  authority  brought  for 
ward,  for  a  practitioner  to  be  the  medium  of  transmitting  con 
tagion  and  death  to  his  patients.  Dr.  Copland  lays  down  rules 
similar  to  those  suggested  by  myself,  and  is  therefore  entitled  to 
the  same  epithet  for  so  doing.  Medical  Dictionary,  New  York. 
1852.  Article,  Puerperal  States  and  Diseases. 

If  there  is  any  appetite  for  facts  so  craving  as  to  be  yet  unap* 


172  MEDICAL  ESSAYS. 

peased,  —  lassata,  necdum  satiata,  —  more  can  be  obtained.  Dt 
Hodge  remarks  that  "  the  frequency  and  importance  of  this  sin 
gular  circumstance  (that  the  disease  is  occasionally  more  prev 
alent  with  one  practitioner  than  another)  has  been  exceedingly 
overrated."  More  than  thirty  strings  of  cases,  more  than  two 
hundred  and  fifty  sufferers  from  puerperal  fever,  more  than  one 
hundred  and  thirty  deaths  appear  as  the  results  of  a  sparing  es 
timate  of  such  among  the  facts  I  have  gleaned  as  could  be  nu 
merically  valued.  These  facts  constitute,  we  may  take  it  for 
granted,  but  a  small  fraction  of  those  that  have  actually  occurred. 
The  number  of  them  might  be  greater,  but  "  't  is  enough,  't  will 
serve,"  in  Mercutio's  modest  phrase,  so  far  as  frequency  is  con 
cerned.  For  a  just  estimate  of  the  importance  of  the  singular 
circumstance,  it  might  be  proper  to  consult  the  languid  surviv 
ors,  the  widowed  husbands,  and  the  motherless  children,  as 
well  as  "  the  unfortunate  accoucheur." 


m. 

CURRENTS  AND   COUNTER-CURRENTS  IN  MEDI 
CAL  SCIENCE.- 


<t>foi(S  lijrpol  " 
"  Facilitate  magis  quam  violentia." 

HlPPOCBATES. 

OUR  Annual  Meeting  never  fails  to  teach  us  at  least 
one  lesson.  The  art  whose  province  it  is  to  heal  and 
to  save  cannot  protect  its  own  ranks  from  the  inroads 
of  disease  and  the  waste  of  the  Destroyer. 

Seventeen  of  our  associates  have  been  taken  from  us 
since  our  last  Anniversary.  Most  of  them  followed 
their  calling  in  the  villages  or  towns  that  lie  among 
the  hills  or  along  the  inland  streams.  Only  those  who 
have  lived  the  kindly,  mutually  dependent  life  of  the 
country,  can  tell  how  near  the  physician  who  is  the 
main  reliance  in  sickness  of  all  the  families  through 
out  a  thinly  settled  region  comes  to  the  hearts  of  the 
people  among  whom  he  labors,  how  they  value  him 
while  living,  how  they  cherish  his  memory  when  dead. 
For  these  friends  of  ours  who  have  gone  before,  there 
is  now  no  more  toil;  they  start  from  their  slum 
bers  no  more  at  the  cry  of  pain  ;  they  sally  forth  no 
more  into  the  storms  ;  they  ride  no  longer  over  the 
lonely  roads  that  knew  them  so  well  ;  their  wheels  are 
rusting  on  their  axles  or  rolling  with  other  burdens  ; 

*  An  Address  delivered  before  the  Massachusetts  Medical 
Society,  at  the  Annual  Meeting,  May  30,  1860. 


174  MEDICAL  ESSAYS. 

their  watchful  eyes  are  closed  to  all  the  sorrows  they 
lived  to  soothe.  Not  one  of  these  was  famous  in  the 
great  world  ;  some  were  almost  unknown  beyond  their 
own  immediate  circle.  But  they  have  left  behind  them 
that  loving  remembrance  which  is  better  than  fame, 
and  if  their  epitaphs  are  chiselled  briefly  in  stone,  they 
are  written  at  full  length  on  living  tablets  in  a  thou 
sand  homes  to  which  they  carried  their  ever-welcome 
aid  and  sympathy. 

One  whom  we  have  lost,  very  widely  known  and 
honored,  was  a  leading  practitioner  of  this  city.  His 
image  can  hardly  be  dimmed  in  your  recollection,  as 
he  stood  before  you  only  three  years  ago,  filling  the 
same  place  with  which  I  am  now  honored.  To  speak 
of  him  at  all  worthily,  would  be  to  write  the  history  of 
professional  success,  won  without  special  aid  at  starting, 
by  toil,  patience,  good  sense,  pure  character,  and  pleas 
ing  manners  ;  won  in  a  straight  uphill  ascent,  without 
one  breathing-space  until  he  sat  down,  not  to  rest,  but 
to  die.  If  prayers  could  have  shielded  him  from  the 
stroke,  if  love  could  have  drawn  forth  the  weapon,  and 
skill  could  have  healed  the  wound,  this  passing  tribute 
might  have  been  left  to  other  lips  and  to  another  gen 
eration. 

Let  us  hope  that  our  dead  have  at  last  found  that 
rest  which  neither  summer  nor  winter,  nor  day  nor 
night,  had  granted  to  their  unending  earthly  labors ! 
And  let  us  remember  that  our  duties  to  our  brethren 
do  not  cease  when  they  become  unable  to  share  our 
toils,  or  leave  behind  them  in  want  and  woe  those  whom 
their  labor  had  supported.  It  is  honorable  to  the  Pro 
fession  that  it  has  organized  an  Association  a  for  the 
relief  of  its  suffering  members  and  their  families ;  it 
a  The  Massachusetts  Medical  Benevolent  Society. 


CURRENTS  AND  COUNTER-CURRENTS.     175 

owes  this  tribute  to  the  ill-rewarded  industry  and  sac 
rifices  of  its  less  fortunate  brothers  who  wear  out  health 
and  life  in  the  service  of  humanity.  I  have  great 
pleasure  in  referring  to  this  excellent  movement,  which 
gives  our  liberal  profession  a  chance  to  show  its  liber 
ality,  and  serves  to  unite  us  all,  the  successful  and 
those  whom  fortune  has  cast  down,  in  the  bonds  of  a 
true  brotherhood. 

A  medical  man,  as  he  goes  about  his  daily  business 
after  twenty  years  of  practice,  is  apt  to  suppose  that  he 
treats  his  patients  according  to  the  teachings  of  his  ex 
perience.  No  doubt  this  is  true  to  some  extent ;  to 
what  extent  depending  much  on  the  qualities  of  the  in 
dividual.  But  it  is  easy  to  prove  that  the  prescriptions 
of  even  wise  physicians  are  very  commonly  founded  on 
something  quite  different  from  experience.  Experience 
must  be  based  on  the  permanent  facts  of  nature.  But 
a  glance  at  the  prevalent  modes  of  treatment  of  any 
two  successive  generations  will  show  that  there  is  a 
changeable  as  well  as  a  permanent  element  in  the  art 
of  healing  ;  not  merely  changeable  as  diseases  vary,  or 
as  new  remedies  are  introduced,  but  changeable  by  the 
going  out  of  fashion  of  special  remedies,  by  the  deca 
dence  of  a  popular  theory  from  which  their  fitness  was 
deduced,  or  other  cause  not  more  significant.  There  is 
no  reason  to  suppose  that  the  present  time  is  essentially 
different  in  this  respect  from  any  other.  Much,  there 
fore,  which  is  now  very  commonly  considered  to  be  the 
result  of  experience,  will  be  recognized  in  the  next,  or 
in  some  succeeding  generation,  as  no  such  result  at  all, 
but  as  a  foregone  conclusion,  based  on  some  prevalent 
belief  or  fashion  of  the  time. 

There  are,  of  course,  in  every  calling,  those  who  ga 


176  MEDICAL  ESSAYS. 

about  the  work  of  the  day  before  them,  doing  it  ac 
cording  to  the  rules  of  their  craft,  and  asking  no  ques 
tions  of  the  past  or  of  the  future,  or  of  the  aim  and 
end  to  which  their  special  labor  is  contributing.  These 
often  consider  and  call  themselves  practical  men. 
They  pull  the  oars  of  society,  and  have  no  leisure  to 
watch  the  currents  running  this  or  that  way ;  let  theo 
rists  and  philosophers  attend  to  them.  In  the  mean 
time,  however,  these  currents  are  carrying  the  practical 
men,  too,  and  all  their  work  may  be  thrown  away,  and 
worse  than  thrown  away,  if  they  do  not  take  knowl 
edge  of  them  and  get  out  of  the  wrong  ones  and  into 
the  right  ones  as  soon  as  they  may.  Sir  Edward  Parry 
and  his  party  were  going  straight  towards  the  pole  in 
one  of  their  arctic  expeditions,  travelling  at  the  rate  of 
ten  miles  a  day.  But  the  ice  over  which  they  travelled 
was  drifting  straight  towards  the  equator,  at  the  rate  of 
twelve  miles  a  day,  and  yet  no  man  among  them  would 
have  known  that  he  was  travelling  two  miles  a  day 
backward  unless  he  had  lifted  his  eyes  from  the  track  in 
which  he  was  plodding.  It  is  not  only  going  backward 
that  the  plain  practical  workman  is  liable  to,  if  he  will 
not  look  up  and  look  around ;  he  may  go  forward  to 
ends  he  little  dreams  of.  It  is  a  simple  business  for  a 
mason  to  build  up  a  niche  in  a  wall ;  but  what  if,  a 
hundred  years  afterwards  when  the  wall  is  torn  down, 
the  skeleton  of  a  murdered  man  drop  out  of  the  niche  ? 
It  was  a  plain  practical  piece  of  carpentry  for  a  Jew 
ish  artisan  to  fit  two  pieces  of  timber  together  accord 
ing  to  the  legal  pattern  in  the  time  of  Pontius  Pilate  j 
he  asked  no  questions,  perhaps,  but  we  know  what 
burden  the  cross  bore  on  the  morrow !  And  so,  with 
subtler  tools  than  trowels  or  axes,  the  statesman  who 
works  in  policy  without  principle,  the  theologian  who 


CURRENTS  AND  COUNTER-CURRENTS.      177 

works  in  forms  without  a  soul,  the  physician  who, 
calling  himself  a  practical  man,  refuses  to  recognize 
the  larger  laws  which  govern  his  changing  practice, 
may  all  find  that  they  have  been  building  truth  into 
the  wall,  and  hanging  humanity  upon  the  cross. 

The  truth  is,  that  medicine,  professedly  founded  on 
observation,  is  as  sensitive  to  outside  influences,  polit 
ical,  religious,  philosophical,  imaginative,  as  is  the  ba 
rometer  to  the  changes  of  atmospheric  density.  The 
oretically  it  ought  to  go  on  its  own  straightforward 
inductive  path,  without  regard  to  changes  of  govern 
ment  or  to  fluctuations  of  public  opinion.  But  look 
a  moment  while  I  clash  a  few  facts  together,  and  see 
if  some  sparks  do  not  reveal  by  their  light  a  closer 
relation  between  the  Medical  Sciences  and  the  con 
ditions  of  Society  and  the  general  thought  of  the  time, 
than  would  at  first  be  suspected. 

Observe  the  coincidences  between  certain  great  po 
litical  and  intellectual  periods  and  the  appearance  of 
illustrious  medical  reformers  and  teachers.  It  was  in 
the  age  of  Pericles,  of  Socrates,  of  Plato,  of  Phidias, 
that  Hippocrates  gave  to  medical  knowledge  the  form 
which  it  retained  for  twenty  centuries.  With  the  world- 
conquering  Alexander,  the  world-embracing  Aristotle, 
appropriating  anatomy  and  physiology,  among  his 
manifold  spoils  of  study,  marched  abreast  of  his  royal 
pupil  to  wider  conquests.  Under  the  same  Ptolemies 
who  founded  the  Alexandrian  Library  and  Museum, 
and  ordered  the  Septuagint  version  of  the  Hebrew 
Scriptures,  the  infallible  Herophilus"  made  those  six 
hundred  dissections  of  which  Tertullian  accused  him, 
and  the  sagacious  Erasistratus  introduced  his  mild 

"  "  Contradicere  Herophilo  in  anatomicis,  est  contradicere 
evangelium,"  was  a  saying  of  Fallopius. 


178  MEDICAL  ESSAYS. 

antiphlogistic  treatment  in  opposition  to  the  polyphar 
macy  and  antidotal  practice  of  his  time.  It  is  signifi« 
cant  that  the  large-minded  Galen  should  have  been 
the  physician  and  friend  of  the  imperial  philosopher 
Marcus  Aurelius.  The  Arabs  gave  laws  in  various 
branches  of  knowledge  to  those  whom  their  arms  had 
invaded,  or  the  terror  of  their  spreading  dominion  had 
reached,  and  the  point  from  which  they  started  was, 
as  Humboldt  acknowledges,  "the  study  of  medicine, 
by  which  they  long  ruled  the  Christian  Schools,"" 
and  to  which  they  added  the  department  of  chemical 
pharmacy. 

Look  at  Vesalius,  the  contemporary  of  Luther. 
Who  can  fail  to  see  one  common  spirit  in  the  radical 
ecclesiastic  and  the  reforming  court-physician  ?  Both 
still  to  some  extent  under  the  dominion  of  the  letter : 
Luther  holding  to  the  real  presence  ;  Vesalius  actually 
causing  to  be  drawn  and  engraved  two  muscles  which 
he  knew  were  not  found  in  the  human  subject,  be 
cause  they  had  been  described  by  Galen,  from  dissec 
tions  of  the  lower  animals.6  Both  breaking  through 
old  traditions  in  the  search  of  truth ;  one,  knife  in 
hand,  at  the  risk  of  life  and  reputation,  the  other  at 
the  risk  of  fire  and  fagot,  with  that  mightier  weapon 
which  all  the  devils  could  not  silence,  though  they  had 
been  thicker  than  the  tiles  on  the  house-tops.  How 
much  the  physician  of  the  Catholic  Charles  V.  had  in 
common  with  the  great  religious  destructive,  may  be 
guessed  by  the  relish  with  which  he  tells  the  story  how 
certain  Pavian  students  exhumed  the  body  of  an  "  ele- 
gans  scortum,"  or  lovely  dame  of  ill  repute,  the  favor- 

•  Cosmos,  ii.  587. 

6  Opera  Omnia,  Basilese,  1555.     Lib.  II.  tab.  V.,  VI.  pp.  225, 

228 


CURRENTS  AND  COUNTER-CURRENTS.     179 

ite  of  a  monk  of  the  order  of  St.  Anthony,  who  does 
not  seem  to  have  resisted  temptation  so  well  as  the 
founder  of  his  order."  We  have  always  ranked  the 
physician  Rabelais  among  the  early  reformers,  but  I 
do  not  know  that  Vesalius  has  ever  been  thanked  for 
his  hit  at  the  morals  of  the  religious  orders,  or  for 
turning  to  the  good  of  science  what  was  intended  for 
the  "  benefit  of  clergy." 

Our  unfortunate  medical  brother,  Michael  Servetus, 
the  spiritual  patient  to  whom  the  theological  moxa  was 
applied  over  the  entire  surface  for  the  cure  of  his  her 
esy,  came  very  near  anticipating  Harvey.*  The  same 
quickened  thought  of  the  time  which  led  him  to  dis 
pute  the  dogma  of  the  Church,  opened  his  mind  to  the 
facts  which  contradicted  the  dogmas  of  the  Faculty. 

Harvey  himself  was  but  the  posthumous  child  of 
the  great  Elizabethan  period.  Bacon  was  at  once  his 
teacher  and  his  patient.  The  founder  of  the  new  in 
ductive  philosophy  had  only  been  dead  two  years 
when  the  treatise  on  the  Circulation,  the  first-fruit  of 
the  Restoration  of  Science,  was  given  to  the  world. 

And  is  it  to  be  looked  at  as  a  mere  accidental  coin 
cidence,  that  while  Napoleon  was  modernizing  the  po 
litical  world,  Bichat  was  revolutionizing  the  science  of 
life  and  the  art  that  is  based  upon  it ;  that  while  the 
young  general  was  scaling  the  Alps,  the  young  sur 
geon  was  climbing  the  steeper  summits  of  unexplored 

•  Opera  Omnia,  Basileae,  1555.     Lib.  V.  cap.  15,  p.  663. 

*  "  Non  per  parietem  cordis  medium,  ut  vulgo  creditur,  sed 
magno  artificio,  a  dextro  cordis  ventriculo,  longe  per  pulmones 
tractu,  et  a  vena  arteriosa,  in  arteriam  venosam  transfunditur." 
—  Bostock's  Physiology,  note  to  p.  211.     1  cite  the  passage  on 
account  of  the  calling  in  question  of  the  claims  of  Servetus  by 
^.mede'e  Pichot.     Life  and  Labors  of  Sir  Charles  Bell,  London, 
i860,  p.  3. 


180  MEDICAL  ESSAYS. 

nature ;  that  the  same  year  read  the  announcement  of 
those  admirable  "  Kesearches  on  Life  and  Death,"  and 
the  bulletins  of  the  battle  of  Marengo  ? 

If  we  come  to  our  own  country,  who  can  fail  to  rec 
ognize  that  Benjamin  Rush,  the  most  conspicuous  of 
American  physicians,  was  the  intellectual  offspring  of 
the  movement  which  produced  the  Revolution  ?  "  The 
same  hand,"  says  one  of  his  biographers,  "  which  sub 
scribed  the  declaration  of  the  political  independence  of 
these  States,  accomplished  their  emancipation  from 
medical  systems  formed  in  foreign  countries,  and 
wholly  unsuitable  to  the  state  of  diseases  in  America." 

Following  this  general  course  of  remark,  I  propose 
to  indicate  in  a  few  words  the  direction  of  the  main 
intellectual  current  of  the  time,  and  to  point  out  more 
particularly  some  of  the  eddies  which  tend  to  keep  the 
science  and  art  of  medicine  from  moving  with  it,  or 
even  to  carry  them  backwards. 

The  two  dominant  words  of  our  time  are  law  and 
average,  both  pointing  to  the  uniformity  of  the  order 
of  being  in  which  we  live.  Statistics  have  tabulated 
everything,  —  population,  growth,  wealth,  crime,  dis 
ease.  We  have  shaded  maps  showing  the  geographical 
distribution  of  larceny  and  suicide.  Analysis  and 
classification  have  been  at  work  upon  all  tangible  and 
visible  objects.  The  Positive  Philosophy  of  Comte  has 
only  given  expression  to  the  observing  and  computing 
mind  of  the  nineteenth  century. 

In  the  mean  time,  the  great  stronghold  of  intellect 
ual  conservatism,  traditional  belief,  has  been  assailed 
by  facts  which  would  have  been  indicted  as  blasphemy 
but  a  few  generations  ago.  Those  new  tables  of  the 
law,  placed  in  the  hands  of  the  geologist  by  the  same 


CURRENTS   AND   COUNTER-CURRENTS.  181 

living  God  who  spoke  from  Sinai  to  the  Israelites  of 
old,  have  remodelled  the  beliefs  of  half  the  civilized 
world.  The  solemn  scepticism  of  science  has  replaced 
the  sneering  doubts  of  witty  philosophers.  The  more 
positive  knowledge  we  gain,  the  more  we  incline  to 
question  all  that  has  been  received  without  absolute 
proof. 

As  a  matter  of  course,  this  movement  has  its  partial 
reactions.  The  province  of  faith  is  claimed  as  a  port 
free  of  entry  to  unsupported  individual  convictions. 
The  tendency  to  question  is  met  by  the  unanalyzing 
instinct  of  reverence.  The  old  church  calls  back  its 
frightened  truants.  Some  who  have  lost  their  hered 
itary  religious  belief  find  a  resource  in  the  revelations 
of  Spiritualism.  By  a  parallel  movement,  some  of 
those  who  have  become  medical  infidels  pass  over  tc 
the  mystic  band  of  believers  in  the  fancied  miracles  of 
Homo30pathy. 

Under  these  influences  transmitted  to,  or  at  least 
shared  by,  the  medical  profession,  the  old  question  be 
tween  "  Nature,"  so  called,  and  "  Art,"  or  professional 
tradition,  has  reappeared  with  new  interest.  I  say  the 
old  question,  for  Hippocrates  stated  the  case  on  the 
side  of  "  Nature  "  more  than  two  thousand  years  ago.* 
Miss  Florence  Nightingale,  —  and  if  I  name  her  next 
to  the  august  Father  of  the  Healing  Art,  its  noblest 
daughter  well  deserves  that  place  of  honor,  —  Miss 
Florence  Nightingale  begins  her  late  volume  with  a 
paraphrase  of  his  statement.  But  from  a  very  early 
tune  to  this  there  has  always  been  a  strong  party 
against  "Nature."  Themison  called  the  practice  of 
Hippocrates  "  a  meditation  upon  death."  Dr.  Rush 
says :  "  It  is  impossible  to  calculate  the  mischief  which 
•  Epidemics,  book  vi.  sect.  5. 


182  MEDICAL  ESSAYS. 

Hippocrates  has  done,  by  first  marking  Nature  with  his 
name  and  afterwards  letting  her  loose  upon  sick  peo 
ple.  Millions  have  perished  by  her  hands  in  all  ages 
and  countries."  Sir  John  Forbes,  whose  defence  of 
"  Nature  "  in  disease  you  all  know,  and  to  the  testi 
monial  in  whose  honor  four  of  your  Presidents  have 
contributed,  has  been  recently  greeted,  on  retiring 
from  the  profession,  with  a  wish  that  his  retirement 
had  been  twenty  years  sooner,  and  the  opinion  that  no 
man  had  done  so  much  to  destroy  the  confidence  of  the 
public  in  the  medical  profession. 

In  this  Society  we  have  had  the  Hippocratic  and  the 
Themisonic  side  fairly  represented.  The  treatise  of 
one  of  your  early  Presidents  on  the  Mercurial  Treat 
ment  is  familiar  to  my  older  listeners.  Others  who 
have  held  the  same  office  have  been  noted  for  the  bold 
ness  of  their  practice,  and  even  for  partiality  to  the 
use  of  complex  medication. 

On  the  side  of  "  Nature  "  we  have  had,  first  of  all, 
that  remarkable  discourse  on  Self-Limited  Diseases," 
which  has  given  the  key-note  to  the  prevailing  medical 
tendency  of  this  neighborhood,  at  least,  for  the  quarter 
of  a  century  since  it  was  delivered.  Nor  have  we 
forgotten  the  address  delivered  at  Springfield  twenty 
years  later,6  full  of  good  sense  and  useful  suggestions, 
to  one  of  which  suggestions  we  owe  the  learned,  im 
partial,  judicious,  well-written  Prize  Essay  of  Dr.  Wor- 
thington  Hooker.*  We  should  not  omit  from  the  list 

•  On  Self-Limited  Diseases.    A  Discourse  delivered  before  the 
Massachusetts  Medical  Society,  at  their  Annual  Meeting,  May 
27,  1885.     By  Jacob  Bigelow,  M.  D. 

•  Search  out  the  Secrets  of  Nature.    By  Augustus  A.  Gould, 
M.  D.     Read  at  the  Annual  Meeting,  June  27,  1855. 

•  Rational  Therapeutics.     A  Prize  Essay.     By  Worthingtou 
Hooker,  M.  D.,  of  New  Haven.    Boston.    1857. 


CURRENTS  AND  COUNTER-CURRENTS.     183 

the  important  address  of  another  of  our  colleagues," 
showing  by  numerous  cases  the  power  of  Nature  in 
healing  compound  fractures  to  be  much  greater  than 
is  frequently  supposed,  —  affording,  indeed,  more  strik 
ing  illustrations  than  can  be  obtained  from  the  history 
of  visceral  disease,  of  the  supreme  wisdom,  forethought, 
and  adaptive  dexterity  of  that  divine  Architect,  as 
shown  in  repairing  the  shattered  columns  which  sup 
port  the  living  temple  of  the  body. 

We  who  are  on  the  side  of  "  Nature "  please  our. 
selves  with  the  idea  that  we  are  in  the  great  current 
in  which  the  true  intelligence  of  the  time  is  moving. 
We  believe  that  some  who  oppose,  or  fear,  or  de 
nounce  our  movement  are  themselves  caught  in  vari 
ous  eddies  that  set  back  against  the  truth.  And  we  do 
most  earnestly  desire  and  most  actively  strive,  that 
Medicine,  which,  it  is  painful  to  remember,  has  been 
spoken  of  as  "  the  withered  branch  of  science  "  at  a 
meeting  of  the  British  Association,  shall  be  at  length 
brought  fully  to  share,  if  not  to  lead,  the  great  wave 
of  knowledge  which  rolls  with  the  tides  that  circle  the 
globe. 

If  there  is  any  State  or  city  which  might  claim  to 
be  the  American  headquarters  of  the  nature-trusting 
heresy,  provided  it  be  one,  that  State  is  Massachusetts, 
and  that  city  is  its  capital.  The  effect  which  these 
doctrines  have  upon  the  confidence  reposed  in  the  pro 
fession  is  a  matter  of  opinion.  For  myself,  I  do  not 
believe  this  confidence  can  be  impaired  by  any  investi 
gations  which  tend  to  limit  the  application  of  trouble 
some,  painful,  uncertain,  or  dangerous  remedies.  Nay, 

"  On  the  Treatment  of  Compound  and  Complicated  Fractures. 
By  William  J.  Walker,  M.  IX  Read  at  the  Annual  Meeting, 
May  29,  1845. 


184  MEDICAL  ESSAYS. 

I  will  venture  to  say  this,  that  if  every  specific  were  to 
fail  utterly,  if  the  cinchona  trees  all  died  out,  and  the 
arsenic  mines  were  exhausted,  and  the  sulphur  regions 
were  burned  up,  if  every  drug  from  the  vegetable,  ani 
mal,  and  mineral  kingdom  were  to  disappear  from  the 
market,  a  body  of  enlightened  men,  organized  as  a  dis 
tinct  profession,  would  be  required  just  as  much  as 
now,  and  respected  and  trusted  as  now,  whose  province 
should  be  to  guard  against  the  causes  of  disease,  to 
eliminate  them  if  possible  when  still  present,  to  order 
all  the  conditions  of  the  patient  so  as  to  favor  the  ef 
forts  of  the  system  to  right  itself,  and  to  give  those 
predictions  of  the  course  of  disease  which  only  experi 
ence  can  warrant,  and  which  in  so  many  cases  relieve 
the  exaggerated  fears  of  sufferers  and  their  friends,  or 
warn  them  in  season  of  impending  danger.  Great  as 
the  loss  would  be  if  certain  active  remedies  could  no 
longer  be  obtained,  it  would  leave  the  medical  profes 
sion  the  most  essential  part  of  its  duties,  and  all,  and 
more  than  all,  its  present  share  of  honors ;  for  it  would 
be  the  death-blow  to  charlatanism,  which  depends  for 
its  success  almost  entirely  on  drugs,  or  at  least  on  a 
nomenclature  that  suggests  them. 

There  is  no  offence,  then,  or  danger  in  expressing 
the  opinion,  that,  after  all  which  has  been  said,  the 
community  is  still  overdosed.  The  best  proof  of  it  is, 
that  no  families  take  so  little  medicine  as  those  of  doc 
tors,  except  those  of  apothecaries,  and  that  old  practi 
tioners  are  more  sparing  of  active  medicines  than 
younger  ones.a  The  conclusion  from  these  facts  is  one 

a  Dr.  James  Jackson  has  kindly  permitted  me  to  make  the 
following  extract  from  a  letter  just  received  by  him  from  Sir 
James  Clark,  and  dated  May  26,  1860:  — 

"  As  u  physician  advances  in  age,  he  generally,  I  think,  places 


CURRENTS  AND  COUNTER-CURRENTS.     185 

which  the  least  promising  of  Dr.  Howe's  pupils  in  the 
mental  department  could  hardly  help  drawing. 

Part  of  the  blame  of  over-medication  must,  I  fear, 
rest  with  the  profession,  for  yielding  to  the  tendency 
to  self-delusion,  which  seems  inseparable  from  the 
practice  of  the  art  of  healing.  I  need  only  touch  on 
the  common  modes  of  misunderstanding  or  misapply 
ing  the  evidence  of  nature. 

First,  there  is  the  natural  incapacity  for  sound  ob 
servation,  which  is  like  a  faulty  ear  in  music.  We  see 
this  in  many  persons  who  know  a  good  deal  about 
books,  but  who  are  not  sharp-sighted  enough  to  buy  a 
horse  or  deal  with  human  diseases. 

Secondly,  there  is  in  some  persons  a  singular  inabil 
ity  to  weigh  the  value  of  testimony  j  of  which,  I  think, 
from  a  pretty  careful  examination  of  his  books,  Hahn. 
emann  affords  the  best  specimen  outside  the  walls  of 
Bedlam. 

The  inveterate  logical  errors  to  which  physicians 
have  always  been  subject  are  chiefly  these :  — 

The  mode  of  inference  per  enumerationem  simpli- 
cem,  in  scholastic  phrase  ;  that  is,  counting  only  their 
favorable  cases.  This  is  the  old  trick  illustrated  in 
Lord  Bacon's  story  of  the  gifts  of  the  shipwrecked 
people,  hung  up  in  the  temple.  —  Behold !  they  vowed 
these  gifts  to  the  altar,  and  the  gods  saved  them.  Ay, 
said  a  doubting  bystander,  but  how  many  made  vows 
of  gifts  and  were  shipwrecked  notwithstanding  ?  The 
numerical  system  is  the  best  corrective  of  this  and  sim 
ilar  errors.  The  arguments  commonly  brought  against 
its  application  to  all  matters  of  medical  observation, 
treatment  included,  seem  to  apply  rather  to  the  tabu- 
less  confidence  in  the  ordinary  medical  treatment  than  he  didj 
not  only  during  his  early,  but  even  his  middle  period  of  life." 


186  MEDICAL  ESSAYS. 

lation  of  facts  ill  observed,  or  improperly  classified, 
than  to  the  method  itself. 

The  post  hoc  ergo  propter  hoc  error :  he  got  well 
after  taking  my  medicine ;  therefore  in  consequence  of 
taking  it. 

The  false  induction  from  genuine  facts  of  observa 
tion,  leading  to  the  construction  of  theories  which  are 
then  deductively  applied  in  the  face  of  the  results  of 
direct  observation.  The  school  of  Broussais  has  fur 
nished  us  with  a  good  example  of  this  error. 

And  lastly,  the  error  which  Sir  Thomas  Browne 
calls  giving  "  a  reason  of  the  golden  tooth ;  "  that  is, 
assuming  a  falsehood  as  a  fact,  and  giving  reasons  for 
it,  commonly  fanciful  ones,  as  is  constantly  done  by 
that  class  of  incompetent  observers  who  find  their 
"  golden  tooth  "  in  the  fabulous  effects  of  the  homreo- 
pathic  materia  medica,  —  which  consists  of  sugar  of 
milk  and  a  nomenclature. 

Another  portion  of  the  blame  rests  with  the  public 
itself,  which  insists  on  being  poisoned.  Somebody 
buys  all  the  quack  medicines  that  build  palaces  for  the 
mushroom,  say  rather,  the  toadstool  millionaires.  Who 
is  it  ?  These  people  have  a  constituency  of  millions. 
The  popular  belief  is  all  but  universal  that  sick  per 
sons  should  feed  on  noxious  substances.  One  of  our 
members  was  called  not  long  since  to  a  man  with  a 
terribly  sore  mouth.  On  inquiry  he  found  that  the 
man  had  picked  up  a  box  of  unknown  pills,  in  Howard 
Street,  and  had  proceeded  to  take  them,  on  general 
principles,  pills  being  good  for  people.  They  hap 
pened  to  contain  mercury,  and  hence  the  trouble  for 
which  he  consulted  our  associate. 

The  outside  pressure,  therefore,  is  immense  upon 
the  physician,  tending  to  force  him  to  active  treatment 


CURRENTS  AND  COUNTER-CURRENTS.     187 

of  some  kind.  Certain  old  superstitions,  still  linger 
ing  in  the  mind  of  the  public,  and  not  yet  utterly  ex 
pelled  from  that  of  the  profession,  are  at  the  bottom 
of  this,  or  contribute  to  it  largely.  One  of  the  most 
ancient  is,  that  disease  is  a  malignant  agency,  or  enti 
ty,  to  be  driven  out  of  the  body  by  offensive  substances9 
as  the  smoke  of  the  fish's  heart  and  liver  drove  the 
devil  out  of  Tobit's  bridal  chamber,  according  to  the 
Apochrypha.  Epileptics  used  to  suck  the  blood  from 
the  wounds  of  dying  gladiators."  The  Hon.  Robert 
Boyle's  little  book  was  published  some  twenty  or  thirty 
years  before  our  late  President,  Dr.  Holyoke,  was  born.6 
In  it  he  recommends,  as  internal  medicines,  most  of 
the  substances  commonly  used  as  fertilizers  of  the  soil. 
His  "Album  Grsecum  "  is  best  left  untranslated,  and  his 
"Zebethum  Occidentale  "  is  still  more  transcendentally 
unmentionable  except  in  a  strange  dialect.  It  sounds 
odiously  to  us  to  hear  him  recommend  for  dysentery  a 
powder  made  from  "  the  sole  of  an  old  shoe  worn  by 
some  man  that  walks  much."  Perhaps  nobody  here 
ever  heard  of  tying  a  stocking,  which  had  been  worn 
during  the  day,  round  the  neck  at  night  for  a  sore 
throat.  The  same  idea  of  virtue  in  unlovely  secre 
tions  ! e 

Even  now  the  Homoeopathists  have  been  introducing 
the  venom  of  serpents,  under  the  learned  title  of 
Lachesis,  and  outraging  human  nature  with  infusions 
of  the  pediculus  capitis  ;  that  is,  of  course,  as  we 
understand  their  dilutions,  the  names  of  these  things  ; 

a  Plinii  Hist.  Mundi.  lib.  xxviii.  c.  4. 

*  A  Collection  of  Choice  and  Safe  Remedies.     The  Fifth  Edi 
tion,  corrected.    London,  1712.    Dr.  Holyoke  was  born  in  1728. 

*  The  idea  is  very  ancient.     "  Sordea  hominis  " —  "  Sudore  et 
oleo  medicinam  facientibus."  —  Plin.  xxviii.  4. 


188  MEDICAL  ESSAYS. 

for  if  a  fine-tooth-comb  insect  were  drowned  in  Lake 
Superior,  we  cannot  agree  with  them  in  thinking  that 
every  drop  of  its  waters  would  be  impregnated  with 
all  the  pedicular  virtues  they  so  highly  value.  They 
know  what  they  are  doing.  They  are  appealing  to 
the  detestable  old  superstitious  presumption  in  favor 
of  whatever  is  nauseous  and  noxious  as  being  good  for 
the  sick. 

Again,  we  all  occasionally  meet  persons  stained  with 
nitrate  of  silver,  given  for  epilepsy.  Read  what  Dr. 
Martin  says,  about  the  way  in  which  it  came  to  be 

«/      *  v 

used,  in  his  excellent  address  before  the  Norfolk 
County  Medical  Society,  and  the  evidence  I  can  show, 
but  have  not  time  for  now,  and  then  say  what  you 
think  of  the  practice  which  on  such  presumptions  turns 
a  white  man  as  blue  as  the  double-tattooed  King  of 
the  Cannibal  Islands !  [Note  A.~\ 

If  medical  superstitions  have  fought  their  way  down 
through  all  the  rationalism  and  scepticism  of  the  nine 
teenth  century,  of  course  the  theories  of  the  schools, 
supported  by  great  names,  adopted  into  the  popular 
belief  and  incorporated  with  the  general  mass  of  mis 
apprehension  with  reference  to  disease,  must  be  ex 
pected  to  meet  us  at  every  turn  in  the  shape  of  bad 
practice  founded  on  false  doctrine.  A  French  patient 
complains  that  his  blood  heats  him,  and  expects  his 
doctor  to  bleed  him.  An  English  or  American  one 
says  he  is  bilious,  and  will  not  be  easy  without  a  dose 
of  calomel.  A  doctor  looks  at  a  patient's  tongue,  sees 
it  coated,  and  says  the  stomach  is  foul ;  his  head  full 
of  the  old  saburral  notion  which  the  extreme  inflam 
mation-doctrine  of  Broussais  did  so  much  to  root  out, 
but  which  still  leads,  probably,  to  much  needless  and 
injurious  wrong  of  the  stomach  and  bowels  by  evacu- 


CURRENTS   AND   COUNTER-CURRENTS.  189 

ants,  when  all  they  want  is  to  be  let  alone.  It  is  so 
hard  to  get  anything  out  of  the  dead  hand  of  medical 
tradition !  The  mortmain  of  theorists  extinct  in  sci 
ence  clings  as  close  as  that  of  ecclesiastics  defunct  in 
law. 

One  practical  hint  may  not  be  out  of  place  here.  It 
seems  to  be  sometimes  forgotten,  by  those  who  must 
know  the  fact,  that  the  tongue  is  very  different,  ana* 
tomically  and  physiologically,  from  the  stomach.  Its 
condition  does  not  in  the  least  imply  a  similar  one  of 
the  stomach,  which  is  a  very  different  structure,  cov 
ered  with  a  different  kind  of  epithelium,  and  furnished 
with  entirely  different  secretions.  A  silversmith  will, 
for  a  dollar,  make  a  small  hoe,  of  solid  silver,  which 
will  last  for  centuries,  and  will  give  a  patient  more 
comfort,  used  for  the  removal  of  the  accumulated  epi 
thelium  and  fungous  growths  which  constitute  the 
"  fur,"  than  many  a  prescription  with  a  splitfooted  I{7 
before  it,  addressed  to  the  parts  out  of  reach. 

I  think  more  of  this  little  implement  on  account  of 
its  agency  in  saving  the  Colony  at  Plymouth  in  the 
year  1623.  Edward  Winslow  heard  that  Massasoit 
was  sick  and  like  to  die.  He  found  him  with  a  house 
ful  of  people  about  him,  women  rubbing  his  arms  and 
legs,  and  friends  "making  such  a  hellish  noise"  as 
they  probably  thought  would  scare  away  the  devil  of 
sickness.  Winslow  gave  him  some  conserve,  washed 
his  mouth,  scraped  his  tongue,  which  was  in  a  horrid 
state,  got  down  some  drink,  made  him  some  broth, 
dosed  him  with  an  infusion  of  strawberry  leaves  and 
sassafras  root,  and  had  the  satisfaction  of  seeing  him 
rapidly  recover.  Massasoit,  full  of  gratitude,  revealed 
the  plot  which  had  been  formed  to  destroy  the  colo 
nists,  whereupon  the  Governor  ordered  Captain  Miles 


190  MEDICAL  ESSAYS. 

Standish  to  see  to  them ;  who  thereupon,  as  everybody 
remembers,  stabbed  Pecksuot  with  his  own  knife,  broke 
up  the  plot,  saved  the  colony,  and  thus  rendered  Mas 
sachusetts  and  the  Massachusetts  Medical  Society  a 
possibility,  as  they  now  are  a  fact  before  us.a  So  much 
for  this  parenthesis  of  the  tongue-scraper,  which  helped 
to  save  the  young  colony  from  a  much  more  serious 
scrape,  and  may  save  the  Union  yet,  if  a  Presidential 
candidate  should  happen  to  be  taken  sick  as  Massasoit 
was,  and  his  tongue  wanted  cleaning,  —  which  process 
would  not  hurt  a  good  many  politicians,  with  or  with 
out  a  typhoid  fever. 

Again,  see  how  the  "  bilious  "  theory  works  in 
every-day  life  here  and  now,  illustrated  by  a  case  from 
actual  life.  A  youthful  practitioner,  whose  last  molars 
have  not  been  a  great  while  cut,  meets  an  experienced 
and  noted  physician  in  consultation.  This  is  the  case. 
A  slender,  lymphatic  young  woman  is  suckling  two 
lusty  twins,  the  intervals  of  suction  being  occupied  on 
her  part  with  palpitations,  headaches,  giddiness,  throb 
bing  in  the  head,  and  various  nervous  symptoms,  her 
cheeks  meantime  getting  bloodless,  and  her  strength 
running  away  in  company  with  her  milk.  The  old  ex 
perienced  physician,  seeing  the  yellowish  waxy  look 
which  is  common  in  anaemic  patients,  considers  it  a 
"  bilious "  case,  and  is  for  giving  a  rousing  emetic. 
Of  course,  he  has  to  be  wheedled  out  of  this,  a  recipe 
is  written  for  beefsteaks  and  porter,  the  twins  are 
ignominiously  expelled  from  the  anaemic  bosom,  and 
forced  to  take  prematurely  to  the  bottle,  and  this  pro 
lific  mother  is  saved  for  future  usefulness  in  the  line 
of  maternity. 

•  Winslow's  Good  News  from  New  England,  or  a  Relation,  etc. 
chap.  20,  21. 


CURRENTS  AND  COUNTER-CURRENTS.     191 

The  practice  of  making  a  profit  on  the  medicine 
ordered  has  been  held  up  to  reprobation  by  one  at 
least  of  the  orators  who  have  preceded  me.  That  the 
effect  of  this  has  been  ruinous  in  English  practice  I 
cannot  doubt,  and  that  in  this  country  the  standard  of 
practice  was  in  former  generations  lowered  through 
the  same  agency  is  not  unlikely.  I  have  seen  an  old 
account-book  in  which  the  physician  charged  an  extra 
price  for  gilding  his  rich  patients'  pills.  If  all  medi 
cine  were  very  costly,  and  the  expense  of  it  always 
came  out  of  the  physician's  fee,  it  would  really  be  a 
less  objectionable  arrangement  than  this  other  most  per 
nicious  one.  He  would  naturally  think  twice  before 
he  gave  an  emetic  or  cathartic  which  evacuated  his 
own  pocket,  and  be  sparing  of  the  cholagogues  that 
emptied  the  biliary  ducts  of  his  own  wallet,  unless  he 
were  sure  they  were  needed.  If  there  is  any  temptation, 
it  should  not  be  in  favor  of  giving  noxious  agents,  as 
it  clearly  must  be  in  the  case  of  English  druggists  and 
"  General  Practitioners."  The  complaint  against  the 
other  course  is  a  very  old  one.  Pliny,  inspired  with 
as  truly  Roman  a  horror  of  quackery  as  the  elder 
Cato,  —  who  declared  that  the  Greek  doctors  had 
sworn  to  exterminate  all  barbarians,  including  the 
Romans,  with  their  drugs,  but  is  said  to  have  phy 
sicked  his  own  wife  to  death,  notwithstanding, — Pliny 
says,  in  so  many  words,  that  the  cerates  and  cata 
plasms,  plasters,  collyria,  and  antidotes,  so  abundant 
in  his  tune,  as  in  more  recent  days,  were  mere  tricks 
to  make  money. 

A  pretty  strong  eddy,  then,  or  rather  many  eddies, 
setting  constantly  back  from  the  current  of  sober  ob 
servation  of  nature,  in  the  direction  of  old  superstitions 


192  MEDICAL  ESSAYS. 

and  fancies,  of  exploded  theories,  of  old  ways  of  making 
money,  which  are  very  slow  to  pass  out  of  fashion ! 
But  there  are  other  special  American  influences  which 
we  are  bound  to  take  cognizance  of.  If  I  wished  t«. 
show  a  student  the  difficulties  of  getting  at  truth  from 
medical  experience,  I  would  give  him  the  history  of 
epilepsy  to  read.  If  I  wished  him  to  understand  the 
tendencies  of  the  American  medical  mind,  its  sanguine 
enterprise,  its  self-confidence,  its  audacious  handling  of 
Nature,  its  impatience  with  her  old-fashioned  ways  of 
taking  time  to  get  a  sick  man  well,  I  would  make  him 
read  the  life  and  writings  of  Benjamin  Rush.  Dr. 
Rush  thought  and  said  that  there  were  twenty  tunes 
more  intellect  and  a  hundred  times  more  knowledge  in 
the  country  in  1799  than  before  the  Revolution.  His 
own  mind  was  in  a  perpetual  state  of  exaltation  pro 
duced  by  the  stirring  scenes  in  which  he  had  taken  a 
part,  and  the  quickened  life  of  the  time  in  which  he 
lived.  It  was  not  the  state  to  favor  sound,  calm  obser 
vation.  He  was  impatient,  and  Nature  is  profoundly 
imperturbable.  We  may  adjust  the  beating  of  our 
hearts  to  her  pendulum  if  we  will  and  can,  but  we  may 
be  very  sure  that  she  will  not  change  the  pendulum's 
rate  of  going  because  our  hearts  are  palpitating.  He 
thought  he  had  mastered  yellow-fever.  "  Thank  God," 
he  said,  "  out  of  one  hundred  patients  whom  I  have 
visited  or  prescribed  for  this  day,  I  have  lost  none." 
Where  was  all  his  legacy  of  knowledge  when  Norfolk 
was  decimated  ?  Where  was  it  when  the  blue  flies 
were  buzzing  over  the  coffins  of  the  unburied  dead 
piled  up  in  the  cemetery  of  New  Orleans,  at  the  edge 
of  the  huge  trenches  yawning  to  receive  them  ? 

One  such  instance  will  do  as  well  as  twenty.     Dr. 
Rush  must  have  been  a  charming  teacher,  as  he  was  an 


CURRENTS  AND  COUNTER-CURRENTS.     193 

admirable  man.  He  was  observing,  rather  than  a 
sound  observer  j  eminently  observing,  curious,  even, 
about  all  manner  of  things.  But  he  could  not  help 
feeling  as  if  Nature  had  been  a  good  deal  shaken  by 
the  Declaration  of  Independence,  and  that  American 
art  was  getting  to  be  rather  too  much  for  her,  —  es 
pecially  as  illustrated  in  his  own  practice.  He  taught 
thousands  of  American  students,  he  gave  a  direction  to 
the  medical  mind  of  the  country  more  than  any  other 
one  man  ;  perhaps  he  typifies  it  better  than  any  other. 
It  has  clearly  tended  to  extravagance  in  remedies  and 
trust  in  remedies,  as  in  everything  else.  How  could  a 
people  which  has  a  revolution  once  in  four  years,  which 
has  contrived  the  Bowie-knife  and  the  revolver,  which 
has  chewed  the  juice  out  of  all  the  superlatives  in  the 
language  in  Fourth  of  July  orations,  and  so  used  up 
its  epithets  in  the  rhetoric  of  abuse  that  it  takes  two 
great  quarto  dictionaries  to  supply  the  demand ;  which 
insists  in  sending  out  yachts  and  horses  and  boys  to 
out-sail,  out-run,  out-fight,  and  checkmate  all  the  rest 
of  creation  ;  how  could  such  a  people  be  content  with 
any  but  "  heroic  "  practice  ?  What  wonder  that  the 
stars  and  stripes  wave  over  doses  of  ninety  grains  of 
sulphate  of  quinine,"  and  that  the  American  eagle 
screams  with  delight  to  see  three  drachms  of  calomel 
given  at  a  single  mouthful  ?  6 

Add  to  this  the  great  number  of  Medical  Journals, 
all  useful,  we  hope,  most  of  them  necessary,  we  trust, 

•  More  strictly,  ninety-six  grains  in  two  hours.  —  Dunglison's 
Practice,  1842,  vol.  ii.  p.  520.     Eighty  grains  in  one  dose. — 
Ibid.  p.  536.     Ninety-six  grains  of  sulphate  of  quinine  are  equal 
to  eight  ounces  of  good  bark.  —  Wood  if  Bache. 

*  Pereira,  ii.  614.      Quoted  from  Christison's  Treatise  on  Pot* 


194  MEDICAL  ESSAYS. 

many  of  them  excellently  well  conducted,  but  which 
must  find  something  to  fill  their  columns,  and  so  print 
all  the  new  plans  of  treatment  and  new  remedies  they 
can  get  hold  of,  as  the  newspapers,  from  a  similar 
necessity,  print  the  shocking  catastrophes  and  terrible 
murders. 

Besides  all  this,  here  are  we,  the  great  body  of  teach 
ers  in  the  numberless  medical  schools  of  the  Union, 
some  of  us  lecturing  to  crowds  who  clap  and  stamp  in 
the  cities,  some  of  us  wandering  over  the  country,  like 
other  professional  fertilizers,  to  fecundate  the  minds  of 
less  demonstrative  audiences  at  various  scientific  sta 
tions;  all  of  us  talking  habitually  to  those  supposed 
to  know  less  than  ourselves,  and  loving  to  claim  as 
much  for  our  art  as  we  can,  not  to  say  for  our  own 
schools,  and  possibly  indirectly  for  our  own  practical 
skill.  Hence  that  annual  crop  of  introductory  lectures ; 
the  useful  blossoming  into  the  ornamental,  as  the  cab 
bage  becomes  glorified  in  the  cauliflower ;  that  lecture- 
room  literature  of  adjectives,  that  declamatory  exag 
geration,  that  splendid  show  of  erudition  borrowed  from 
D'Israeli,  and  credited  to  Lord  Bacon  and  the  rest, 
which  have  suggested  to  our  friends  of  the  Medical 
Journals  an  occasional  epigram  at  our  expense.  Hence 
the  tendency  in  these  productions,  and  in  medical  lec 
tures  generally,  to  overstate  the  efficacy  of  favorite 
methods  of  cure,  and  hence  the  premium  offered  for 
showy  talkers  rather  than  sagacious  observers,  for  the 
men  of  adjectives  rather  than  of  nouns  substantive  in 
the  more  ambitious  of  these  institutions.0 

•  "  Ingeniorum  Grsecise  flatu  impellimur.  Palamque  est,  ut 
quisque  inter  istos  loquendo  polleat,  imperatorem  illico  vitze 
nostrae  necisque  fieri."  —  Plin.  Hist.  Mundi,  xxix.  1.  I  hope  I 
may  use  the  old  Roman  liberty  of  speech  without  offence. 


CURRENTS  AND  COUNTER-CURRENTS.     195 

Such  are  some  of  the  eddies  in  which  we  are  liable 
to  become  involved  and  carried  back  out  of  the  broad 
stream  of  philosophical,  or,  in  other  words,  truth-lov 
ing,  investigations.  The  causes  of  disease,  in  the 
mean  time,  have  been  less  earnestly  studied  in  the 
eagerness  of  the  search  for  remedies.  Speak  softly! 
Women  have  been  borne  out  from  an  old-world  hospi 
tal,  two  in  one  coffin,  that  the  horrors  of  their  prison-, 
house  might  not  be  known,  while  the  very  men  who 
were  discussing  the  treatment  of  the  disease  were  stu 
pidly  conveying  the  infection  from  bed  to  bed,  as  rat- 
killers  carry  their  poisons  from  one  household  to  an* 
other.  Do  not  some  of  you  remember  that  I  have  had 
to  fight  this  private-pestilence  question  against  a  scep 
ticism  which  sneered  in  the  face  of  a  mass  of  evidence 
such  as  the  calm  statisticians  of  the  Insurance  office 
could  not  listen  to  without  horror  and  indignation  ? a 
Have  we  forgotten  what  is  told  in  one  of  the  books 
published  under  our  own  sanction,  that  a  simple  meas 
ure  of  ventilation,  proposed  by  Dr.  John  Clark,  had 
saved  more  than  sixteen  thousand  children's  lives  in  a 
single  hospital  ?  b  How  long  would  it  have  taken  small 
doses  of  calomel  and  rhubarb  to  save  as  many  chil 
dren?  These  may  be  useful  in  prudent  hands,  but 
how  insignificant  compared  to  the  great  hygienic  con 
ditions  !  Causes,  causes,  and  again  causes,  —  more 
and  more  we  fall  back  on  these  as  the  chief  objects  of 
our  attention.  The  shortest  system  of  medical  prac 
tice  that  I  know  of  is  the  oldest,  but  not  the  worst.  It 
is  older  than  Hippocrates,  older  than  Chiron  the  Gen* 

"  "  The  Contagiousness  of  Puerperal  Fever."  —  N.  E.  Quar. 
Jour,  of  Medicine  and  Surgery,  April,  1843.  Reprinted,  with 
Additions.  Boston:  Ticknor  &  Fields.  1855. 

•  Collins's  Midwifery,  p.  312     (In  Lib.  of  Prac.  Med.) 


196  MEDICAL  ESSAYS. 

taur.  Nature  taught  it  to  the  first  mother  when  she 
saw  her  first-born  child  putting  some  ugly  pebble  or 
lurid  berry  into  its  mouth.  I  know  not  in  what  lan 
guage  it  was  spoken,  but  I  know  that  in  English  it 
would  sound  thus  :  Spit  it  out ! 

Art  can  do  something  more  than  say  this.  It  can 
sometimes  reach  the  pebble  or  berry  after  it  has  been 
swallowed.  But  the  great  thing  is  to  keep  these  things 
out  of  children's  mouths,  and  as  soon  as  they  are  be 
yond  our  reach,  to  be  reasonable  and  patient  with  Na 
ture,  who  means  well,  but  does  not  like  to  hurry,  and 
who  took  nine  calendar  months,  more  or  less,  to  every 
mother's  son  among  us,  before  she  thought  he  was  fit 
to  be  shown  to  the  public. 

Suffer  me  now  to  lay  down  a  few  propositions, 
whether  old  or  new  it  matters  little,  not  for  your  im 
mediate  acceptance,  nor  yet  for  your  hasty  rejection, 
but  for  your  calm  consideration. 

But  first,  there  are  a  number  of  terms  which  we  are 
in  the  habit  of  using  in  a  vague  though  not  unintelligi 
ble  way,  and  which  it  is  as  well  now  to  define.  These 
terms  are  the  tools  with  which  we  are  to  work,  and  the 
first  thing  is  to  sharpen  them.  It  is  nothing  to  us  that 
they  have  been  sharpened  a  thousand  times  before; 
they  always  get  dull  in  the  using,  and  every  new  work 
man  has  a  right  to  carry  them  to  the  grindstone  and 
sharpen  them  to  suit  himself. 

Nature,  in  medical  language,  as  opposed  to  Art, 
means  trust  in  the  reactions  of  the  living  system 
against  ordinary  normal  impressions. 

Art,  in  the  same  language,  as  opposed  to  Nature, 
means  an  intentional  resort  to  extraordinary  abnormal 
impressions  for  the  relief  of  disease. 

The  reaction  of  the  living  system  is  the  essence  of 


CURRENTS  AND  COUNTER-CURRENTS.      197 

both.  Food  is  nothing,  if  there  is  no  digestive  act  to 
respond  to  it.  We  cannot  raise  a  blister  on  a  dead 
man,  or  hope  that  a  carminative  forced  between  his 
lips  will  produce  its  ordinary  happy  effect. 

Disease,  dis-ease,  —  disturbed  quiet,  uncomfortable- 
ness,  —  means  imperfect  or  abnormal  reaction  of  the 
living  system,  and  its  more  or  less  permanent  results. 

Food,  in  its  largest  sense,  is  whatever  helps  to  build 
up  the  normal  structures,  or  to  maintain  their  natural 
actions. 

Medicine,  in  distinction  from  food,  is  every  unnatu 
ral  or  noxious  agent  applied  for  the  relief  of  disease. 

Physic  means  properly  the  Natural  art,  and  Physi 
cian  is  only  the  Greek  synonyme  of  Naturalist. 

With  these  few  explanations  I  proceed  to  unfold  the 
propositions  I  have  mentioned. 

Disease  and  death,  if  we  may  judge  by  the  records 
of  creation,  are  inherently  and  essentially  necessary  in 
the  present  order  of  things.  A  perfect  intelligence, 
trained  by  a  perfect  education,  could  do  no  more  than 
keep  the  laws  of  the  physical  and  spiritual  universe. 
An  imperfect  intelligence,  imperfectly  taught,  —  and 
this  is  the  condition  of  our  finite  humanity,  —  will  cer 
tainly  fail  to  keep  all  these  laws  perfectly.  Disease  is 
one  of  the  penalties  of  one  of  the  forms  of  such  failure. 
It  is  prefigured  in  the  perturbations  of  the  planets,  in 
the  disintegration  of  the  elemental  masses ;  it  has  left 
its  traces  in  the  fossil  organisms  of  extinct  creations." 

"  Professor  Agassiz  has  kindly  handed  me  the  following  note: 
"  There  are  abnormal  structures  in  animals  of  all  ages  anterior 
to  the  creation  of  mankind.  Malformed  specimens  of  Crinoids 
*re  known  from  the  Triassic  and  Jurassic  deposits.  Malformed 
and  diseased  bones  of  tertiary  mammalia  have  been  collected  in 
the  caverns  of  Gailenreuth  with  traces  of  healing." 


198  MEDICAL  ESSAYS. 

But  it  is  especially  the  prerogative,  I  had  almost  said 
privilege,  of  educated  and  domesticated  beings,  from 
man  down  to  the  potato,  serving  to  teach  them,  and 
such  as  train  them,  the  laws  of  life,  and  to  get  rid  of 
those  who  will  not  mind  or  cannot  be  kept  subject  to 
these  laws. 

Disease,  being  always  an  effect,  is  always  in  exact 
proportion  to  the  sum  of  its  causes,  as  much  in  the  case 
of  Spigelius,  who  dies  of  a  scratch,  as  in  that  of  the  man 
who  recovers  after  an  iron  bar  has  been  shot  through 
his  brain.  The  one  prevalent  failing  of  the  medical 
art  is  to  neglect  the  causes  and  quarrel  with  the  effect. 
There  are  certain  general  facts  which  include  a  good 
deal  of  what  is  called  and  treated  as  disease.  Thus, 
there  are  two  opposite  movements  of  life  to  be  seen  in 
cities  and  elsewhere,  belonging  to  races  which,  from 
various  persistent  causes,  are  breeding  down  and  tend 
ing  to  run  out,  and  to  races  which  are  breeding  up,  or 
accumulating  vital  capital,  —  a  descending  and  an  as 
cending  series.  Let  me  give  an  example  of  each ;  and 
that  I  may  incidentally  remove  a  common  inpression 
about  this  country  as  compared  with  the  Old  World, 
an  impression  which  got  tipsy  with  conceit  and  stag 
gered  into  the  attitude  of  a  formal  proposition  in  the 
work  of  Dr.  Robert  Knox,tf  I  will  illustrate  the  down- 
Professor  Jeffries  Wyman  has  also  favored  me  with  an  inter 
esting  communication,  from  which  I  extract  this  statement:  — 

"Necrosis,  caries,  anchylosis,  and  osteophytes  have  been  ob 
served  in  fossil  bones.  Zeis  (Leipsic,  1856)  has  written  a  me 
moir  on  the  specimens  of  this  nature  contained  in  the  Royal 
Cabinet  of  Natural  History  at  Dresden." 

•  "  Already  the  Anglo-Saxon  rears  with  difficulty  his  offspring 
in  Australia :  it  is  the  same  in  most  parts  of  America.  But  for 
the  supplies  they  receive  from  Europe  the  race  would  perish, 
even  in  these  most  healthy  climates." —  The  Races  of  Men, 
Philadelphia,  1850,  p.  317. 


CURRENTS  AND  COUNTER-CURRENTS.      199 

ward  movement  from  English  experience,  and  the  up 
ward  movement  from  a  family  history  belonging  to  this 
immediate  neighborhood. 

Miss  Nightingale  speaks  of  "  the  fact  so  often  seen 
of  a  great-grandmother,  who  was  a  tower  of  physical 
vigor,  descending  into  a  grandmother  perhaps  a  little 
less  vigorous,  but  still  sound  as  a  bell,  and  healthy  to 
the  core,  into  a  mother  languid  and  confined  to  her 
carriage  and  house,  and  lastly  into  a  daughter  sickly 
and  confined  to  her  bed."  So  much  for  the  descend 
ing  English  series ;  now  for  the  ascending  American 
series. 

Something  more  than  one  hundred  and  thirty  years 
ago  there  graduated  at  Harvard  College  a  delicate 
youth,  who  lived  an  invalid  life  and  died  at  the  age  of 
about  fifty.  His  two  children  were  both  of  moderate 
physical  power,  and  one  of  them  diminutive  in  stature. 
The  next  generation  rose  in  physical  development,  and 
reached  eighty  years  of  age  and  more  in  some  of  its 
members.  The  fourth  generation  was  of  fair  average 
endowment.  The  fifth  generation,  great-great-grand 
children  of  the  slender  invalid,  are  several  of  them  of 
extraordinary  bodily  and  mental  power ;  large  in  stat 
ure,  formidable  alike  with  their  brains  and  their  arms, 
organized  on  a  more  extensive  scale  than  either  of 
their  parents. 

This  brief  account  illustrates  incidentally  the  fallacy 
of  the  universal-degeneration  theory  applied  to  Ameri 
can  life ;  the  same  on  which  one  of  our  countrymen 
has  lately  brought  some  very  forcible  facts  to  bear  in  a 
muscular  discussion  of  which  we  have  heard  rather 
more  than  is  good  for  us.  But  the  two  series,  Ameri 
can  and  English,  ascending  and  descending,  were  ad 
duced  with  the  main  purpose  of  showing  the  immense 


200  MEDICAL   ESSAYS. 

difference  of  vital  endowments  in  different  strains  of 
blood ;  a  difference  to  which  all  ordinary  medication 
is  in  all  probability  a  matter  of  comparatively  trivial 
purport.  Many  affections  which  art  has  to  strive 
against  might  be  easily  shown  to  be  vital  to  the  well- 
being  of  society.  Hydrocephalus,  tabes  mesenterica, 
and  other  similar  maladies,  are  natural  agencies  which 
cut  off  the  children  of  races  that  are  sinking  below  the 
decent  minimum  which  nature  has  established  as  the 
condition  of  viability,  before  they  reach  the  age  of  re 
production.  They  are  really  not  so  much  diseases,  as 
manifestations  of  congenital  incapacity  for  life ;  the 
race  would  be  ruined  if  art  could  ever  learn  always  to 
preserve  the  individuals  subject  to  them.  We  must  do 
the  best  we  can  for  them,  but  we  ought  also  to  know 
what  these  "  diseases  "  mean. 

Again,  invalidism  is  the  normal  state  of  many  or 
ganizations.  It  can  be  changed  to  disease,  but  never 
to  absolute  health  by  medicinal  appliances.  There  are 
many  ladies,  ancient  and  recent,  who  are  perpetually 
taking  remedies  for  irremediable  pains  and  aches. 
They  ought  to  have  headaches  and  back-aches  and 
stomach-aches ;  they  are  not  well  if  they  do  not  have 
them.  To  expect  them  to  live  without  frequent  twinges 
is  like  expecting  a  doctor's  old  chaise  to  go  without 
creaking ;  if  it  did,  we  might  be  sure  the  springs  were 
broken.  There  is  no  doubt  that  the  constant  demand 
for  medicinal  remedies  from  patients  of  this  class  leads 
to  their  over-use  ;  often  in  the  case  of  cathartics,  some 
times  in  that  of  opiates.  I  have  been  told  by  an  intel 
ligent  practitioner  in  a  Western  town,  that  the  constant 
prescription  of  opiates  by  certain  physicians  in  his  vi 
cinity  has  rendered  the  habitual  use  of  that  drug  in  all 
that  region  very  prevalent ;  more  common,  I  should 


CURRENTS   AND   COUNTER-CURRENTS.  201 

think,  than  alcoholic  drunkenness  in  the  most  intem 
perate  localities  of  which  I  have  known  anything.  A 
frightful  endemic  demoralization  betrays  itself  in  the 
frequency  with  which  the  haggard  features  and  droop 
ing  shoulders  of  the  opium-drunkards  are  met  with  in 
the  streets. 

The  next  proposition  I  would  ask  you  to  consider  is 
this:  — 

The  presumption  always  is  that  every  noxious  agent, 
including  medicines  proper,  which  hurts  a  well  man, 
hurts  a  sick  one.  [Note  -5.] 

Let  me  illustrate  this  proposition  before  you  decide 
upon  it.  If  it  were  known  that  a  prize-fighter  were 
to  have  a  drastic  purgative  administered  two  or  three 
days  before  a  contest,  or  a  large  blister  applied  to  hia 
back,  no  one  will  question  that  it  would  affect  the  bet 
ting  on  his  side  unfavorably ;  we  will  say  to  the 
amount  of  five  per  cent.  Now  the  drain  upon  the  re 
sources  of  the  system  produced  in  such  a  case  must 
be  at  its  minimum,  for  the  subject  is  a  powerful  man, 
in  the  prime  of  life,  and  in  admirable  condition.  If 
the  drug  or  the  blister  takes  five  per  cent,  from  his 
force  of  resistance,  it  will  take  at  least  as  large  a  frac 
tion  from  any  invalid.  But  this  invalid  has  to  fight  a 
champion  who  strikes  hard  but  cannot  be  hit  in  return, 
who  will  press  him  sharply  for  breath,  but  will  never 
pant  himself  while  the  wind  can  whistle  through  his 
fleshless  ribs.  The  suffering  combatant  is  liable  to 
want  all  his  stamina,  and  five  per  cent,  may  lose  him 
the  battle. 

All  noxious  agents,  all  appliances  which  are  not  nat 
ural  food  or  stimuli,  all  medicines  proper,  cost  a  pa 
tient,  on  the  average,  five  per  cent,  of  his  vital  force, 
let  us  say.  Twenty  times  as  much  waste  of  force  pro 


202  MEDICAL  ESSAYS. 

duced  by  any  of  them,  that  is,  would  exactly  kill  him, 
nothing  less  than  kill  him,  and  nothing  more.  If  this, 
or  something  like  this,  is  true,  then  all  these  medica 
tions  are,  primd  facie,  injurious. 

In  the  game  of  Life-or-Death,  Rouge  et  Noir,  as 
played  between  the  Doctor  and  the  Sexton,  this  five 
per  cent.,  this  certain  small  injury  entering  into  the 
chances  is  clearly  the  sexton's  perquisite  for  keeping 
the  green  table,  over  which  the  game  is  played,  and 
where  he  hoards  up  his  gains.  Suppose  a  blister  to 
diminish  a  man's  pain,  effusion  or  dyspno3a  to  the  sav 
ing  of  twenty  per  cent,  in  vital  force  ;  his  profit  from 
it  is  fifteen,  in  that  case,  for  it  always  hurts  him  five 
to  begin  with,  according  to  our  previous  assumption. 

Presumptions  are  of  vast  importance  in  medicine, 
as  in  law.  A  man  is  presumed  innocent  until  he  is 
proved  guilty.  A  medicine  —  that  is,  a  noxious  agent, 
like  a  blister,  a  seton,  an  emetic,  or  a  cathartic  —  should 
always  be  presumed  to  be  hurtful.  It  always  is  di 
rectly  hurtful;  it  may  sometimes  be  indirectly  ben« 
eficial.  If  this  presumption  were  established,  and 
disease  always  assumed  to  be  the  innocent  victim  of 
circumstances,  and  not  punishable  by  medicines,  that 
is,  noxious  agents,  or  poisons,  until  the  contrary  was 
shown,  we  should  not  so  frequently  hear  the  remark 
commonly,  perhaps  erroneously,  attributed  to  Sir  Ast 
ley  Cooper,  but  often  repeated  by  sensible  persons, 
that,  on  the  whole,  more  harm  than  good  is  done  by 
medication.  Throw  out  opium,  which  the  Creator 
himself  seems  to  prescribe,  for  we  often  see  the  scarlet 
poppy  growing  in  the  cornfields,  as  if  it  were  foreseen 
that  wherever  there  is  hunger  to  be  fed  there  must 
also  be  pain  to  be  soothed  ;  throw  out  a  few  specifics 
which  our  art  did  not  discover,  and  is  hardly  needed 


CURRENTS  AND  COUNTER-CURRENTS.     203 

to  apply  [Note  C.~\  ;  throw  out  wine,  which  is  a  food, 
and  the  vapors  which  produce  the  miracle  of  anaesthe 
sia,  and  I  firmly  believe  that  if  the  whole  materia 
medica,  as  now  used,  could  be  sunk  to  the  bottom  of 
the  sea,  it  would  be  all  the  better  for  mankind,  —  and 
all  the  worse  for  the  fishes. 

But  to  justify  this  proposition,  I  must  add  that  the 
injuries  inflicted  by  over-medication  are  to  a  great  ex 
tent  masked  by  disease.  Dr.  Hooker  believes  that  the 
typhus  syncopalis  of  a  preceding  generation  in  New 
England  "  was  often  in  fact  a  brandy  and  opium  dis 
ease."  How  is  a  physician  to  distinguish  the  irritation 
produced  by  his  blister  from  that  caused  by  the  inflam 
mation  it  was  meant  to  cure  ?  How  can  he  tell  the 
exhaustion  produced  by  his  evacuants  from  the  col 
lapse  belonging  to  the  disease  they  were  meant  to  re 
move? 

Lastly,  medication  without  insuring  favorable  hygi 
enic  conditions  is  like  amputation  without  ligatures. 
1  had  a  chance  to  learn  this  well  of  old,  when  physi 
cian  to  the  Broad  Street  district  of  the  Boston  Dispen«- 
sary.  There,  there  was  no  help  for  the  utter  want  of 
wholesome  conditions,  and  if  anybody  got  well  under 
my  care,  it  must  have  been  in  virtue  of  the  rough-and- 
tumble  constitution  which  emerges  from  the  struggle 
for  life  in  the  street  gutters,  rather  than  by  the  aid  of 
my  prescriptions. 

But  if  the  materia  medica  were  lost  overboard,  how 
much  more  pains  would  be  taken  in  ordering  all  the 
circumstances  surrounding  the  patient  (as  can  be  done 
everywhere  out  of  the  crowded  pauper  districts),  than 
are  taken  now  by  too  many  who  think  they  do  their 
duty  and  earn  their  money  when  they  write  a  recipe 
for  a  patient  left  in  an  atmosphere  of  domestic  malaria* 


204  MEDICAL  ESSAYS. 

or  to  the  most  negligent  kind  of  nursing !  I  confess 
that  I  should  think  my  chance  of  recovery  from  illness 
less  with  Hippocrates  for  my  physician  and  Mrs.  Gamp 
for  my  nurse,  than  if  I  were  in  the  hands  of  Hahne- 
mann  himself,  with  Florence  Nightingale  or  good  Re 
becca  Taylor  to  care  for  me. 

If  I  am  right  in  maintaining  that  the  presumption 
is  always  against  the  use  of  noxious  agents  in  disease, 
and  if  any  whom  I  might  influence  should  adopt  this 
as  a  principle  of  practice,  they  will  often  find  them 
selves  embarrassed  by  the  imperative  demand  of  pa 
tients  and  their  friends  for  such  agents  where  a  case  is 
not  made  out  against  this  standing  presumption.  I 
must  be  permitted  to  say,  that  I  think  the  French,  a 
not  wholly  uncivilized  people,  are  in  advance  of  the 
English  and  ourselves  in  the  art  of  prescribing  for  the 
sick  without  hurting  them.  And  I  do  confess  that  I 
think  their  varied  ptisans  and  syrups  are  as  much  pref 
erable  to  the  mineral  regimen  of  bug-poison  and  rats 
bane,  so  long  in  favor  on  the  other  side  of  the  Chan 
nel,  as  their  art  of  preparing  food  for  the  table  to  the 
rude  cookery  of  those  hard-feeding  and  much-dosing 
islanders.  We  want  a  reorganized  cuisine  of  invalid- 
ism  perhaps  as  much  as  the  culinary  reform,  for  which 
our  lyceum  lecturers,  and  others  who  live  much  at 
hotels  and  taverns,  are  so  urgent.  Will  you  think  1 
am  disrespectful  if  I  ask  whether,  even  in  Massachu 
setts,  a  dose  of  calomel  is  not  sometimes  given  by  a 
physician  on  the  same  principle  as  that  upon  which  a 
landlord  occasionally  prescribes  bacon  and  eggs,  —  be 
cause  he  cannot  think  of  anything  else  quite  so  handy  ? 
I  leave  my  suggestion  of  borrowing  a  hint  from  French 
practice  to  your  mature  consideration. 

I  may,  however,  call  your  attention,  briefly,  to  the 


CURRENTS   AND   COUNTER-CURRENTS.  205 

singular  fact,  that  English  and  American  practitioners 
are  apt  to  accuse  French  medical  practice  of  inertness^ 
and  French  surgical  practice  of  unnecessary  activity. 
Thus,  Dr.  Bostock  considers  French  medical  treatment, 
with  certain  exceptions,  as  "  decidedly  less  effective  " 
than  that  of  his  own  country."  Mr.  S.  Cooper,  again, 
defends  the  simple  British  practice  of  procuring  union 
by  the  first  intention  against  the  attacks  of  M.  Roux 
and  Baron  Larrey.6  We  have  often  heard  similar 
opinions  maintained  by  our  own  countrymen.  While 
Anglo-American  criticism  blows  hot  or  cold  on  the  two 
departments  of  French  practice,  it  is  not,  I  hope,  in 
decent  to  question  whether  all  the  wisdom  is  necessarily 
with  us  in  both  cases. 

Our  art  has  had  two  or  three  lessons  which  have  a 
deep  meaning  to  those  who  are  willing  to  read  them 
honestly.  The  use  of  water-dressings  in  surgery  com 
pleted  the  series  of  reforms  by  which  was  abolished 
the  "  coarse  and  cruel  practice  "  of  the  older  surgeons, 
who  with  their  dressings  and  acrid  balsams,  their  tents 
and  leaden  tubes,  "  absolutely  delayed  the  cure."  The 
doctrine  of  Broussais,  transient  as  was  its  empire,  re 
versed  the  practice  of  half  of  Christendom  for  a  sea 
son,  and  taught  its  hasty  disciples  to  shun  their  old 
favorite  remedies  as  mortal  poisons.  This  was  not 
enough  permanently  to  shift  the  presumption  about 

•  Hist.  ofMed.,  in  Cyc.  ofPrac.  Med.  vol.  i.  p.  70. 

4  Cooper's  Surg.  Diet.  art. "  Wounds."  Yet  Mr.  John  Bell  gives 
the  French  surgeons  credit  for  introducing  this  doctrine  of  ad 
hesion,  and  accuses  O'Halloran  of  "  rudeness  and  ignorance," 
and  "  bold,  uncivil  language,"  in  disputing  their  teaching.  — 
Princ.  of  Surgery,  vol.  i.  p.  42.  Mr.  Hunter  succeeded  at  last 
in  naturalizing  the  doctrine  and  practice,  but  even  he  had  to 
struggle  against  the  perpetual  jealousy  of  rivals,  and  died  at 
length  assassinated  by  an  insult. 


206  MEDICAL  ESSAYS. 

drugs  where  it  belonged,  and  so  at  last,  just  as  the 
sympathetic  powder  and  the  Unguentum  Armarium 
came  in  a  superstitious  age  to  kill  out  the  abuses  of 
external  over-medication,  the  solemn  farce  of  Homoeop 
athy  was  enacted  in  the  face  of  our  own  too  credulous 
civilization,  that  under  shelter  of  its  pretences  the 
"  inward  bruises "  of  over-drugged  viscera  might  be 
allowed  to  heal  by  the  first  intention.  Its  lesson  we 
must  accept,  whether  we  will  or  not ;  its  follies  we  are 
tired  of  talking  about.  The  security  of  the  medical 
profession  against  this  and  all  similar  fancies  is  in  the 
average  constitution  of  the  human  mind  with  regar<J 
to  the  laws  of  evidence. 

My  friends  and  brothers  in  Art  I  There  is  nothing 
to  be  feared  from  the  utterance  of  any  seeming  heresy 
to  which  you  may  have  listened.  I  cannot  compromise 
your  collective  wisdom.  If  I  have  strained  the  truth 
one  hair's  breadth  for  the  sake  of  an  epigram  or  an 
antithesis,  you  are  accustomed  to  count  the  normal 
pulse-beats  of  sound  judgment,  and  know  full  well  how 
to  recognize  the  fever-throbs  of  conceit  and  the  ner 
vous  palpitations  of  rhetoric. 

The  freedom  with  which  each  of  us  speaks  his 
thought  in  this  presence,  belongs  in  part  to  the  assured 
position  of  the  Profession  in  our  Commonwealth,  to 
the  attitude  of  Science,  which  is  always  fearless,  and 
to  the  genius  of  the  soil  on  which  we  stand,  from  which 
Nature  withheld  the  fatal  gift  of  malaria  only  to  fill  it 
with  exhalations  that  breed  the  fever  of  inquiry  in  our 
blood  and  in  our  brain.  But  mainly  we  owe  the  large 
license  of  speech  we  enjoy  to  those  influences  and  priv 
ileges  common  to  us  all  as  self-governing  Americans. 

This  Republic  is  the  chosen  home  of  minorities,  of 


CURRENTS  AND  COUNTER-CURRENTS.     207 

the  less  power  in  the  presence  of  the  greater.  It  is  a 
common  error  to  speak  of  our  distinction  as  consisting 
in  the  rule  of  the  majority.  Majorities,  the  greater 
material  powers,  have  always  ruled  before.  The  his 
tory  of  most  countries  has  been  that  of  majorities,  — 
mounted  majorities,  clad  in  iron,  armed  with  death, 
treading  down  the  tenfold  more  numerous  minorities. 
In  the  old  civilizations  they  root  themselves  like  oaks 
in  the  soil ;  men  must  live  in  their  shadow  or  cut  them 
down.  With  us  the  majority  is  only  the  flower  of  the 
passing  noon,  and  the  minority  is  the  bud  which  may 
open  in  the  next  morning's  sun.  We  must  be  tolerant, 
for  the  thought  which  stammers  on  a  single  tongue  to 
day  may  organize  itself  in  the  growing  consciousness 
of  the  time,  and  come  back  to  us  like  the  voice  of  the 
multitudinous  waves  of  the  ocean  on  the  morrow. 

Twenty-five  years  have  passed  since  one  of  your 
honored  Presidents  spoke  to  this  Society  of  certain 
limitations  to  the  power  of  our  Art,  now  very  generally 
conceded.  Some  were  troubled,  some  were  almost 
angry,  thinking  the  Profession  might  suffer  from  such 
concessions.  It  has  certainly  not  suffered  here ;  if,  as 
some  affirm,  it  has  lost  respect  anywhere,  it  was  prob 
ably  for  other,  and  no  doubt  sufficient  reasons. 

Since  that  time  the  civilization  of  this  planet  has 
changed  hands.  Strike  out  of  existence  at  this  mo 
ment  every  person  who  was  breathing  on  that  day, 
May  27,  1835,  and  every  institution  of  society,  every 
art  and  every  science  would  remain  intact  and  com 
plete  in  the  living  that  would  be  left.  Every  idea  the 
world  then  held  has  been  since  dissolved  and  recrystal- 
lized. 

We  are  repeating  the  same  process.  Not  to  make 
silver  shrines  for  our  old  divinities,  even  though  by 


208  MEDICAL  ESSAYS. 

this  craft  we  should  have  our  wealth,  was  this  Society 
organized  and  carried  on  by  the  good  men  and  true 
who  went  before  us.  Not  for  this,  but  to  melt  the  gold 
out  of  the  past,  though  its  dross  should  fly  in  dust  to 
all  the  winds  of  heaven,  to  save  all  our  old  treasures  of 
knowledge  and  mine  deeply  for  new,  to  cultivate  that 
mutual  respect  of  which  outward  courtesy  is  the  sign, 
to  work  together,  to  feel  together,  to  take  counsel  to 
gether,  and  to  stand  together  for  the  truth,  now,  al 
ways,  here,  everywhere ;  for  this  our  fathers  instituted, 
and  we  accept,  the  offices  and  duties  of  this  time-hon 
ored  Society. 


IV. 

BORDER  LINES  OF  KNOWLEDGE  IN  SOME  PROV 
INCES  OF  MEDICAL  SCIENCE.- 

[THIS  Lecture  appears  as  it  would  have  been  delivered  had  the  time  al 
lowed  been  less  strictly  limited.  Passages  necessarily  omitted  have  been 
restored,  and  points  briefly  touched  have  been  more  fully  considered.  A 
few  notes  have  been  added  for  the  benefit  of  that  limited  class  of  students 
who  care  to  track  an  author  through  the  highways  and  by-ways  of  his 
reading.  I  owe  my  thanks  to  several  of  my  professional  brethren  who 
have  communicated  with  me  on  subjects  with  which  they  are  familiar;  es 
pecially  to  Dr.  John  Dean,  for  the  opportunity  of  profiting  by  his  unpub 
lished  labors,  and  to  Dr.  Hasket  Derby,  for  information  and  references  to 
recent  authorities  relating  to  the  anatomy  and  physiology  of  the  eye.] 

THE  entrance  upon  a  new  course  of  Lectures  is  al 
ways  a  period  of  interest  to  instructors  and  pupils.  As 
the  birth  of  a  child  to  a  parent,  so  is  the  advent  of  a 
new  class  to  a  teacher.  As  the  light  of  the  untried 
world  to  the  infant,  so  is  the  dawning  of  the  light  rest 
ing  over  the  unexplored  realms  of  science  to  the  stu 
dent.  In  the  name  of  the  Faculty  I  welcome  you, 
Gentlemen  of  the  Medical  Class,  new-born  babes  of 
science,  or  lustier  nurslings,  to  this  morning  of  your 
medical  life,  and  to  the  arms  and  the  bosom  of  this  an 
cient  University.  Fourteen  years  ago  I  stood  in  this 
place  for  the  first  time  to  address  those  who  occupied 
these  benches.  As  I  recall  these  past  seasons  of  our 
joint  labors,  I  feel  that  they  have  been  on  the  whole 
prosperous,  and  not  undeserving  of  their  prosperity. 

0  An  Introductory  Lecture  delivered  before  the  Medical  Class 
of  Harvard  University,  November  6,  1861. 


210  MEDICAL  ESSAYS. 

For  it  has  been  my  privilege  to  be  associated  with  a 
body  of  true  and  faithful  workers ;  I  cannot  praise 
them  freely  to  their  faces,  or  I  should  be  proud  to  dis 
course  of  the  harmonious  diligence  and  the  noble  spirit 
in  which  they  have  toiled  together,  not  merely  to  teach 
their  several  branches,  but  to  elevate  the  whole  stand 
ard  of  teaching. 

I  may  speak  with  less  restraint  of  those  gentlemen 
who  have  aided  me  in  the  most  laborious  part  of  my 
daily  duties,  the  Demonstrators,  to  whom  the  succes 
sive  classes  have  owed  so  much  of  their  instruction. 
They  rise  before  me,  the  dead  and  the  living,  in  the 
midst  of  the  most  grateful  recollections.  The  fair, 
manly  face  and  stately  figure  of  my  friend,  Dr.  Sam 
uel  Parkman,  himself  fit  for  the  highest  offices  of 
teaching,  yet  willing  to  be  my  faithful  assistant  in  the 
time  of  need,  come  back  to  me  with  the  long  sigh  of 
regret  for  his  early  loss  to  our  earthly  companionship. 
Every  year  I  speak  the  eulogy  of  Dr.  Ainsworth's  pa 
tient  toil  as  I  show  his  elaborate  preparations.  When 
I  take  down  my  "  American  Cyclopaedia  "  and  borrow 
instruction  from  the  learned  articles  of  Dr.  Kneeland, 
I  cease  to  regret  that  his  indefatigable  and  intelligent 
industry  was  turned  into  a  broader  channel.  And  what 
can  I  say  too  cordial  of  my  long  associated  companion 
and  friend,  Dr.  Hodges,  whose  admirable  skill,  work* 
ing  through  the  swiftest  and  surest  fingers  that  ever 
held  a  scalpel  among  us,  has  delighted  class  after  class, 
and  filled  our  Museum  with  monuments  which  will 
convey  his  name  to  unborn  generations  ? 

This  day  belongs,  however,  not  to  myself  and  my 
recollections,  but  to  all  of  us  who  teach  and  all  of  you 
who  listen,  whether  experts  in  our  specialties  or  aliens 
to  their  mysteries,  or  timid  neophytes  just  entering  the 


BORDER   LINES   IN  MEDICAL   SCIENCE.  211 

portals  of  the  hall  of  science.  Look  in  with  me,  then, 
while  I  attempt  to  throw  some  rays  into  its  interior, 
which  shall  illuminate  a  few  of  its  pillars  and  cornices, 
and  show  at  the  same  time  how  many  niches  and  al 
coves  remain  in  darkness. 

SCIENCE  is  the  topography  of  ignorance.  From  a 
few  elevated  points  we  triangulate  vast  spaces,  inclos 
ing  infinite  unknown  details.  We  cast  the  lead,  and 
draw  up  a  little  sand  from  abysses  we  may  never  reach 
with  our  dredges. 

The  best  part  of  our  knowledge  is  that  which  teaches 
us  where  knowledge  leaves  off  and  ignorance  begins. 
Nothing  more  clearly  separates  a  vulgar  from  a  su 
perior  mind,  than  the  confusion  in  the  first  between 
the  little  that  it  truly  knows,  on  the  one  hand,  and 
what  it  half  knows  and  what  it  thinks  it  knows  on  the 
other. 

That  which  is  true  of  every  subject  is  especially  true 
of  the  branch  of  knowledge  which  deals  with  living 
beings.  Their  existence  is  a  perpetual  death  and  re- 
animation.  Their  identity  is  only  an  idea,  for  we  put 
off  our  bodies  many  times  during  our  lives,  and  dress 
in  new  suits  of  bones  and  muscles. 

"Thou  art  not  thyself; 
For  thou  exist'st  on  many  a  thousand  grains 
That  issue  out  of  dust."  " 

If  it  is  true  that  we  understand  ourselves  but  imper 
fectly  in  health,  this  truth  is  more  signally  manifested 
in  disease,  where  natural  actions  imperfectly  under 
stood,  disturbed  in  an  obscure  way  by  half-seen  causes, 

•  "  Occasio  enim  praeceps  est  propter  artis  materiam,  dico 
autem  corpus,  quod  continue  fluit  et  momento  temporis  trans- 
mutatur."  —  Galen,  Com.  in  Aphorism.  Hippoc.  i.  1. 


212  MEDICAL  ESSAYS. 

are  creeping  and  winding  along  in  the  dark  toward 
their  destined  issue,  sometimes  using  our  remedies  as 
safe  stepping-stones,  occasionally,  it  may  be,  stumbling 
over  them  as  obstacles. 

I  propose  in  this  lecture  to  show  you  some  points  of 
contact  between  our  ignorance  and  our  knowledge  in 
several  of  the  branches  upon  the  study  of  which  you 
are  entering.  I  may  teach  you  a  very  little  directly, 
but  I  hope  much  more  from  the  trains  of  thought  I 
shall  suggest.  Do  not  expect  too  much  ground  to  be 
covered  in  this  rapid  survey.  Our  task  is  only  that  of 
sending  out  a  few  pickets  under  the  starry  flag  of 
science  to  the  edge  of  that  dark  domain  where  the  en 
signs  of  the  obstinate  rebel,  Ignorance,  are  flying  un 
disputed.  We  are  not  making  a  reconnoissance  in 
force,  still  less  advancing  with  the  main  column.  But 
here  are  a  few  roads  along  which  we  have  to  march 
together,  and  we  wish  to  see  clearly  how  far  our  lines 
extend,  and  where  the  enemy's  outposts  begin. 

Before  touching  the  branches  of  knowledge  that 
deal  with  organization  and  vital  functions,  let  us  glance 
at  that  science  which  meets  you  at  the  threshold  of 
your  study,  and  prepares  you  in  some  measure  to  deal 
with  the  more  complex  problems  of  the  living  labora 
tory. 

CHEMISTRY  includes  the  art  of  separating  and  com 
bining  the  elements  of  matter,  and  the  study  of  the 
changes  produced  by  these  operations.  We  can  hardly 
say  too  much  of  what  it  has  contributed  to  our  knowl 
edge  of  the  universe  and  our  power  of  dealing  with  its 
materials.  It  has  given  us  a  catalogue  raisonnS  of 
the  substances  found  upon  our  planet,  and  shown  how 


BORDER  LINES   IN  MEDICAL   SCIENCE.  213 

everything  living  and  dead  is  put  together  from  them. 
It  is  accomplishing  wonders  before  us  every  day,  such 
as  Arabian  story-tellers  used  to  string  together  in  their 
fables.  It  spreads  the  sensitive  film  on  the  artificial 
retina  which  looks  upon  us  through  the  optician's  lens 
for  a  few  seconds,  and  fixes  an  image  that  will  outlive 
its  original.  It  questions  the  light  of  the  sun,  and  de 
tects  the  vaporized  metals  floating  around  the  great 
luminary,  —  iron,  sodium,  lithium,  and  the  rest,  —  as 
if  the  chemist  of  our  remote  planet  could  fill  his  bell- 
glasses  from  its  fiery  atmosphere."  It  lends  the  power 
which  flashes  our  messages  in  thrills  that  leave  the  lazy 
chariot  of  day  behind  them.  It  seals  up  a  few  dark 
grains  in  iron  vases,  and  lo !  at  the  touch  of  a  single 
spark,  rises  in  smoke  and  flame  a  mighty  Afrit  with  a 
voice  like  thunder  and  an  arm  that  shatters  like  an 
earthquake.  The  dreams  of  Oriental  fancy  have  be 
come  the  sober  facts  of  our  every-day  life,  and  the 
chemist  is  the  magician  to  whom  we  owe  them. 

To  return  to  the  colder  scientific  aspect  of  chemis 
try.  It  has  shown  us  how  bodies  stand  affected  to 
each  other  through  an  almost  boundless  range  of  com 
binations.  It  has  given  us  a  most  ingenious  theory  to 
account  for  certain  fixed  relations  in  these  combina 
tions.  It  has  successfully  eliminated  a  great  number 
of  proximate  compounds,  more  or  less  stable,  from  or 
ganic  structures.  It  has  invented  others  which  form 
the  basis  of  long  series  of  well-known  composite  sub 
stances.  In  fact,  we  are  perhaps  becoming  overbur 
dened  with  our  list  of  proximate  principles,  demon 
strated  and  hypothetical. 

How  much  nearer  have  we  come  to  the  secret  of 

•  Scientific  Annual  for  1861.  —  Fairbairn's  Address  before  the 
British  Association,  1861. 


214  MEDICAL  ESSAYS. 

force  than  Lully  and  Geber  and  the  whole  crew  of 
juggling  alchemists  ?  We  have  learned  a  great  deal 
about  the  how,  what  have  we  learned  about  the  why  ? 

Why  does  iron  rust,  while  gold  remains  untarnished, 
and  gold  amalgamate,  while  iron  refuses  the  alliance 
of  mercury  ? 

The  alchemists  called  gold  Sol,  the  sun,  and  iron 
Mars,  and  pleased  themselves  with  fancied  relations 
between  these  substances  and  the  heavenly  bodies,  by 
which  they  pretended  to  explain  the  facts  they  ob 
served.  Some  of  their  superstitions  have  lingered  in 
practical  medicine  to  the  present  day,  but  chemistry 
has  grown  wise  enough  to  confess  the  fact  of  absolute 
ignorance. 

What  is  it  that  makes  common  salt  crystallize  in  the 
form  of  cubes,  and  saltpetre  in  the  shape  of  six-sided 
prisms?  We  see  no  reason  why  it  should  not  have 
been  just  the  other  way,  salt  in  prisms  and  saltpetre 
in  cubes,  or  why  either  should  take  an  exact  geometri 
cal  outline,  any  more  than  coagulating  albumen. 

But  although  we  had  given  up  attempting  to  explain 
the  essential  nature  of  affinities  and  of  crystalline 
types,  we  might  have  supposed  that  we  had  at  least 
fixed  the  identity  of  the  substances  with  which  we  deal, 
and  determined  the  laws  of  their  combination.  All  at 
once  we  find  that  a  simple  substance  changes  face,  puts 
off  its  characteristic  qualities  and  resumes  them  at  will ; 
—  not  merely  when  we  liquefy  or  vaporize  a  solid,  or 
reverse  the  process  ;  but  that  a  solid  is  literally  trans 
formed  into  another  solid  under  our  own  eyes.  We 
thought  we  knew  phosphorus.  We  warm  a  portion  of 
it  sealed  in  an  empty  tube,  for  about  a  week.  It  has 
become  a  brown  infusible  substance,  which  does  not 
shine  hi  the  dark  nor  oxidate  in  the  air.  We  heat  it 


BORDER   LINES   IN   MEDICAL   SCIENCE.  215 

to  500°  F.,  and  it  becomes  common  phosphorus  again. 
We  transmute  sulphur  in  the  same  singular  way.  Na 
ture,  you  know,  gives  us  carbon  in  the  shape  of  coal 
and  in  that  of  the  diamond.  It  is  easy  to  call  these 
changes  by  the  name  allotropism,  but  not  the  less  do 
they  confound  our  hasty  generalizations. 

These  facts  of  allotropism  have  some  corollaries  con 
nected  with  them  rather  startling  to  us  of  the  nine 
teenth  century.  There  may  be  other  transmutations 
possible  besides  those  of  phosphorus  and  sulphur. 
When  Dr.  Prout,  in  1840,  talked  about  azote  and  car 
bon  being  "  formed  "  in  the  living  system,  it  was  looked 
upon  as  one  of  those  freaks  of  fancy  to  which  philos 
ophers,  like  other  men,  are  subject.  But  when  Profes 
sor  Faraday,  in  1851,  says,  at  a  meeting  of  the  British 
Association,  that  "  his  hopes  are  in  the  direction  of 
proving  that  bodies  called  simple  were  really  com 
pounds,  and  may  be  formed  artificially  as  soon  as  we 
are  masters  of  the  laws  influencing  their  combinations," 
—  when  he  comes  forward  and  says  that  he  has  tried 
experiments  at  transmutation,  and  means,  if  his  life  is 
spared,  to  try  them  again,  —  how  can  we  be  surprised 
at  the  popular  story  of  1861,  that  Louis  Napoleon  has 
established  a  gold-factory  and  is  glutting  the  mints  of 
Europe  with  bullion  of  his  own  making? 

And  so  with  reference  to  the  law  of  combinations. 
The  old  maxim  was,  Corpora  non  agunt  nisi  soluta. 
If  two  substances,  a  and  6,  are  inclosed  in  a  glass  ves 
sel,  c,  we  do  not  expect  the  glass  to  change  them,  unless 
a  or  b  or  the  compound  a  b  has  the  power  of  dissolving 
the  glass.  But  if  for  a  I  take  oxygen,  for  b  hydrogen, 
and  for  c  a  piece  of  spongy  platinum,  I  find  the  first 
two  combine  with  the  common  signs  of  combustion  and 
form  water,  the  third  in  the  mean  time  undergoing  no 


216  MEDICAL  ESSAYS. 

perceptible  change.  It  has  played  the  part  of  the  un« 
wedded  priest,  who  marries  a  pair  without  taking  a 
fee  or  having  any  further  relation  with  the  parties. 
We  call  this  catalysis,  catalytic  action,  the  action  of 
presence,  or  by  what  learned  name  we  choose.  Give 
what  name  to  it  we  will,  it  is  a  manifestation  of  power 
which  crosses  our  established  laws  of  combination  at  a 
very  open  angle  of  intersection.  I  think  we  may  find 
an  analogy  for  it  in  electrical  induction,  the  disturbance 
of  the  equilibrium  of  the  electricity  of  a  body  by  the 
approach  of  a  charged  body  to  it,  without  interchange 
of  electrical  conditions  between  the  two  bodies.  But 
an  analogy  is  not  an  explanation,  and  why  a  few  drops 
of  yeast  should  change  a  saccharine  mixture  to  carbonic 
acid  and  alcohol,  —  a  little  leaven  leavening  the  whole 
lump,  —  not  by  combining  with  it,  but  by  setting  a 
movement  at  work,  we  not  only  cannot  explain,  but  the 
fact  is  such  an  exception  to  the  recognized  laws  of  com 
bination  that  Liebig  is  unwilling  to  admit  the  new 
force  at  all  to  which  Berzelius  had  given  the  name  so 
generally  accepted. 

The  phenomena  of  isomerism,  or  identity  of  com 
position  and  proportions  of  constituents  with  difference 
of  qualities,  and  of  isomorphism,  or  identity  of  form  in 
crystals  which  have  one  element  substituted  for  another, 
were  equally  surprises  to  science;  and  although  the 
mechanism  by  which  they  are  brought  about  can  be  to 
a  certain  extent  explained  by  a  reference  to  the  hypo 
thetical  atoms  of  which  the  elements  are  constituted, 
yet  this  is  only  turning  the  difficulty  into  a  fraction 
with  an  infinitesimal  denominator  and  an  infinite  nu 
merator. 

So  far  we  have  studied  the  working  of  force  and  its 
seeming  anomalies  in  purely  chemical  phenomena. 


BORDER   LINES    IN   MEDICAL   SCIENCE.  217 

But  we  soon  find  that  chemical  force  is  developed  by 
various  other  physical  agencies,  —  by  heat,  by  light,  by 
electricity,  by  magnetism,  by  mechanical  agencies ; 
and,  vice  versa,  that  chemical  action  develops  heat, 
light,  electricity,  magnetism,  mechanical  force,  as  we 
see  in  our  matches,  galvanic  batteries,  and  explosive 
compounds.  Proceeding  with  our  experiments,  we  find 
that  every  kind  of  force  is  capable  of  producing  all 
other  kinds,  or,  in  Mr.  Faraday's  language,  that  "  the 
various  forms  under  which  the  forces  of  matter  are 
made  manifest  have  a  common  origin,  or,  in  other 
words,  are  so  directly  related  and  mutually  dependent 
that  they  are  convertible  one  into  another." 

Out  of  this  doctrine  naturally  springs  that  of  the 
conservation  of  force,  so  ably  illustrated  by  Mr.  Grove, 
Dr.  Carpenter,  and  Mr.  Faraday.  This  idea  is  no 
novelty,  though  it  seems  so  at  first  sight.  It  was  main 
tained  and  disputed  among  the  giants  of  philosophy. 
Des  Cartes  and  Leibnitz  denied  that  any  new  motion 
originated  in  nature,  or  that  any  ever  ceased  to  exist ; 
all  motion  being  in  a  circle,  passing  from  one  body  to 
another,  one  losing  what  the  other  gained.  Newton, 
on  the  other  hand,  believed  that  new  motions  were  gen 
erated  and  existing  ones  destroyed.  On  the  first  sup 
position,  there  is  a  fixed  amount  of  force  always 
circulating  in  the  universe.  On  the  second,  the  total 
amount  may  be  increasing  or  diminishing.  You  will 
find  in  the  "  Annual  of  Scientific  Discovery  "  for  1858 
a  very  interesting  lecture  by  Professor  Helmholtz  of 
Bonn,  in  which  it  is  maintained  that  a  certain  poi> 
tion  of  force  is  lost  in  every  natural  process,  being 
converted  into  unchangeable  heat,  so  that  the  universe 
will  come  to  a  stand-still  at  last,  all  force  passing  into 
heat,  and  all  heat  into  a  state  of  equilibrium. 


218  MEDICAL   ESSAYS. 

The  doctrines  of  the  convertibility  or  specific  equiv 
alence  of  the  various  forms  of  force,  and  of  its  con 
servation,  which  is  its  logical  consequence,  are  very 
generally  accepted,  as  I  believe,  at  the  present  time, 
among  physicists.  We  are  naturally  led  to  the  ques 
tion,  What  is  the  nature  of  force  ?  The  three  illustri 
ous  philosophers  just  referred  to  agree  in  attributing 
the  general  movements  of  the  universe  to  the  immedi 
ate  Divine  action."  The  doctrine  of  "  preestablished 
harmony  "  was  an  especial  contrivance  of  Leibnitz  to 
remove  the  Creator  from  unworthy  association  with  the 
less  divine  acts  of  living  beings.  Obsolete  as  this  ex 
pression  sounds  to  our  ears,  the  phrase  laws  of  the 
universe,  which  we  use  so  constantly  with  a  wider  ap 
plication,  appears  to  me  essentially  identical  with  it. 

Force  does  not  admit  of  explanation,  nor  of  proper 
definition,  any  more  than  the  hypothetical  substratum 
of  matter.  If  we  assume  the  Infinite  as  omnipresent, 
omniscient,  omnipotent,  we  cannot  suppose  Him  ex 
cluded  from  any  part  of  His  creation,  except  from 
rebellious  souls  which  voluntarily  exclude  Him  by  the 

"  "  Et  generalem  quod  attinet,  manifestum  mihi  videtur  illam 
[causam]  non  aliam  esse,  quam  Deum  ipsum,  qui  materiam 
sitnul  cum  motu  et  quiete  in  principio  creavit,  jamque  per  solum 
suum  concursum  ordinarium,  tantundem  motus  et  quietis  in  ea 
tola  quantum  tune  posuit  conservat: ....  eodem  plane  modo, 
eademque  ratione  qua  prius  creavit,  eum  etiam  tantundem 
motus  in  ipsa  semper  conservare."  —  Des  Cartes,  Princ.  Phil. 
pt.  ii.  §  xxxvi. 

"  Concursus  Dei,  action!  creaturae  necessarius." —  Leibnitz, 
Op.  torn.  vi.  p.  174. 

"  In  ipso  continentur  et  moventur  universa,  sed  absque  mutua 
passione.  Deus  nihil  patitur  ex  corporum  motibus:  ilia  nullam 
sentiunt  resistentiam  ex  oinniprseseutia  Dei."  — Newton, 
cipia,  lib.  iii.  Schol.  Gen. 


BOEDER  LINES   IN   MEDICAL   SCIENCE.  219 

exercise  of  their  fatal  prerogative  of  free-will."  Force, 
then,  is  the  act  of  immanent  Divinity.  I  find  no  mean 
ing  in  mechanical  explanations.  Newton's  hypothesis 
of  an  ether  filling  the  heavenly  spaces  does  not,  I  con 
fess,  help  my  conceptions.  I  will,  and  the  muscles  of 
my  vocal  organs  shape  my  speech.  God  wills,  and  the 
universe  articulates  His  power,  wisdom,  and  goodness. 
That  is  all  I  know.  There  is  no  bridge  my  mind  can 
throw  from  the  "  immaterial "  cause  to  the  "  material " 
effect. 

The  problem  of  force  meets  us  everywhere,  and  I 
prefer  to  encounter  it  in  the  world  of  physical  phenom 
ena  before  reaching  that  of  living  actions.  It  is  only 
the  name  for  the  incomprehensible  cause  of  certain 
changes  known  to  our  consciousness,  and  assumed  to 
be  outside  of  it.  For  me  it  is  the  Deity  Himself  in  ac 
tion. 

I  can  therefore  see  a  large  significance  in  the  some 
what  bold  language  of  Burdach :  "  There  is  for  me  but 
one  miracle,  that  of  infinite  existence,  and  but  one 
mystery,  the  manner  in  which  the  finite  proceeds  from 
the  infinite.  So  soon  as  we  recognize  this  incomprehen 
sible  act  as  the  general  and  primordial  miracle,  of 
which  our  reason  perceives  the  necessity,  but  the  man 
ner  of  which  our  intelligence  cannot  grasp,  so  soon  as 
we  contemplate  the  nature  known  to  us  by  experience 

"  "  Cum  unaquseque  spatii  particula  sit  semper,  et  unumquodque 
durationis  indivisibile  momentum  ubique ;  certe  rerum  omnium 
Fabricator  ac  Dominus  non  erit  nunquam  nusquam.  Omniprae- 
sens  est  non  per  virtutem  solam,  sed  etiam  per  substantiam ;  nam 
virtus  sine  substantia  subsistere  non  potest."  —  Newton,  loc.  cit, 

"  The  Lord  of  all,  himself  through  all  diffused, 
Sustains  and  is  the  life  of  all  that  lives." 

The  Task,  bk.  vi.  1.  221,  222, 


220  MEDICAL  ESSAYS. 

in  this  light,  there  is  for  us  no  other  impenetrable 
miracle  or  mystery."* 

Let  us  turn  to  a  branch  of  knowledge  which  deals 
with  certainties  up  to  the  limit  of  the  senses,  and  is 
involved  in  no  speculations  beyond  them.  In  certain 
points  of  view,  HUMAN  ANATOMY  may  be  considered 
an  almost  exhausted  science.  From  time  to  time  some 
small  organ  which  had  escaped  earlier  observers  has 
been  pointed  out,  —  such  parts  as  the  tensor  tarsi,  the 
otic  ganglion,  or  the  Pacinian  bodies  ;  but  some  of  our 
best  anatomical  works  are  those  which  have  been  clas 
sic  for  many  generations.  The  plates  of  the  bones  in 
Vesalius,  three  centuries  old,  are  still  masterpieces  of 
accuracy,  as  of  art.  The  magnificent  work  of  Albinus 
on  the  muscles,  published  in  1747,  is  still  supreme  in 
its  department,  as  the  constant  references  of  the  most 
thorough  recent  treatise  on  the  subject,  that  of  Theile, 
sufficiently  show.  More  has  been  done  in  unravelling 
the  mysteries  of  the  fasciae,  but  there  has  been  a  ten 
dency  to  overdo  this  kind  of  material  analysis.  Alex 
ander  Thomson  split  them  up  into  cobwebs,  as  you  may 
see  in  the  plates  to  Velpeau's  Surgical  Anatomy.  I 
well  remember  how  he  used  to  shake  his  head  over  the 
coarse  work  of  Scarpa  and  Astley  Cooper,  —  as  if 
Denner,  who  painted  the  separate  hairs  of  the  beard 
and  pores  of  the  skin  in  his  portraits,  had  spoken 
lightly  of  the  pictures  of  Rubens  and  Vandyk. 

Not  only  has  little  been  added  to  the  catalogue  of 
parts,  but  some  things  long  known  had  become  half- 
forgotten.  Louis  and  others  confounded  the  solitary 
glands  of  the  lower  part  of  the  small  intestine  with 
those  which  "  the  great  Brunner,"  as  Haller  calls  him, 
•  Physiologie  (Trad,  de  Jourdan),  ii.  326, 


BORDER  LINES   IN  MEDICAL   SCIENCE.  221 

described  in  1687  as  being  found  in  the  duodenum. 
The  display  of  the  fibrous  structure  of  the  brain 
seemed  a  novelty  as  shown  by  Spurzheim.  One  is 
startled  to  find  the  method  anticipated  by  Raymond 
Vieussens  nearly  two  centuries  ago.  I  can  hardly 
think  Gordon  had  ever  looked  at  his  figures,  though 
he  names  their  author,  when  he  wrote  the  captious  and 
sneering  article  which  attracted  so  much  attention  in 
the  pages  of  the  "Edinburgh  Review."" 

This  is  the  place,  if  anywhere,  to  mention  any  obser 
vations  I  could  pretend  to  have  made  in  the  course  of 
my  teaching  the  structure  of  the  human  body.  I  can 
make  no  better  show  than  most  of  my  predecessors  in 
this  well-reaped  field.  The  nucleated  cells  found  con 
nected  with  the  cancellated  structure  of  the  bones, 
which  I  first  pointed  out  and  had  figured  in  1847,  and 
have  shown  yearly  from  that  time  to  the  present,  and 
the  fossa  masseterica,  a  shallow  concavity  on  the  ra- 
mus  of  the  lower  jaw,  for  the  lodgment  of  the  masseter 
muscle,  which  acquires  significance  when  examined  by 
the  side  of  the  deep  cavity  on  the  corresponding  part 
hi  some  carnivora  to  which  it  answers,  may  perhaps  be 
claimed  as  deserving  attention.  I  have  also  pleased 
myself  by  making  a  special  group  of  the  six  radiating 
muscles *  which  diverge  from  the  spine  of  the  axis,  or 
second  cervical  vertebra,  and  by  giving  to  it  the  name 
Stella  musculosa  nuchce.  But  this  scanty  catalogue  is 
only  an  evidence  that  one  may  teach  long  and  see  little 
that  has  not  been  noted  by  those  who  have  gone  before 
him.  Of  course  I  do  not  think  it  necessary  to  include 
rare,  but  already  described  anomalies,  such  as  the  epi- 

•June,  1815. 

*  Rectus  capitis  posticus  major,  oUiquus  capitis  inferior,  and 
semispinalis  colli,  on  each  side. 


222  MEDICAL   ESSAYS. 

sternal  bones,  the  rectus  sternalis,  and  other  interesting 
exceptional  formations  I  have  encountered,  which  have 
shown  a  curious  tendency  to  present  themselves  sev 
eral  times  in  the  same  season,  perhaps  because  the 
first  specimen  found  calls  our  attention  to  any  we  may 
subsequently  meet  with. 

The  anatomy  of  the  scalpel  and  the  amphitheatre 
was,  then,  becoming  an  exhausted  branch  of  investiga 
tion.  But  during  the  present  century  the  study  of  the 
human  body  has  changed  its  old  aspect,  and  become 
fertile  in  new  observations.  This  rejuvenescence  was 
effected  by  means  of  two  principal  agencies, — new 
methods  and  a  new  instrument. 

Descriptive  anatomy,  as  known  from  an  early  date, 
is  to  the  body  what  geography  is  to  the  planet.  Now 
geography  was  pretty  well  known  so  long  ago  as  when 
Arrowsmith,  who  was  born  in  1750,  published  his  ad 
mirable  maps.  But  in  that  same  year  was  born  Wer 
ner,  who  taught  a  new  way  of  studying  the  earth,  since 
become  familiar  to  us  all  under  the  name  of  Geology. 

What  geology  has  done  for  our  knowledge  of  the 
earth,  has  been  done  for  our  knowledge  of  the  body  by 
that  method  of  study  to  which  is  given  the  name  of 
General  Anatomy.  It  studies,  not  the  organs  as  such, 
but  the  elements  out  of  which  the  organs  are  con 
structed.  It  is  the  geology  of  the  body,  as  that  is  the 
general  anatomy  of  the  earth.  The  extraordinary 
genius  of  Bichat,  to  whom  more  than  any  other  we 
owe  this  new  method  of  study,  does  not  require  Mr. 
Buckle's  testimony  to  impress  the  practitioner  with  the 
importance  of  its  achievements.  I  have  heard  a  very 
wise  physician  question  whether  any  important  result 
had  accrued  to  practical  medicine  from  Harvey's  dis 
covery  of  the  circulation.  But  Anatomy,  Physiology, 


BORDER  LINES   IN  MEDICAL  SCIENCE.  223 

and  Pathology  have  received  a  new  light  from  this 
novel  method  of  contemplating  the  living  structures, 
which  has  had  a  vast  influence  in  enabling  the  practi 
tioner  at  least  to  distinguish  and  predict  the  course  of 
disease.  We  know  as  well  what  differences  to  expect 
in  the  habits  of  a  mucous  and  of  a  serous  membrane, 
as  what  mineral  substances  to  look  for  in  the  chalk  or 
the  coal  measures.  You  have  only  to  read  Cullen's 
description  of  inflammation  of  the  lungs  or  of  the 
bowels,  and  compare  it  with  such  as  you  may  find  in 
Laennec  or  Watson,  to  see  the  immense  gain  which 
diagnosis  and  prognosis  have  derived  from  general 
anatomy. 

The  second  new  method  of  studying  the  human 
structure,  beginning  with  the  labors  of  Scarpa,  Burns, 
and  Colles,  grew  up  principally  during  the  first  third 
of  this  century.  It  does  not  deal  with  organs,  as  did 
the  earlier  anatomists,  nor  with  tissues,  after  the  man 
ner  of  Bichat.  It  maps  the  whole  surface  of  the  body 
into  an  arbitrary  number  of  regions,  and  studies  each 
region  successively  from  the  surface  to  the  bone,  or  be 
neath  it.  This  hardly  deserves  the  name  of  a  science, 
although  Velpeau  has  dignified  it  with  that  title,  but 
it  furnishes  an  admirable  practical  way  for  the  surgeon 
who  has  to  operate  on  a  particular  region  of  the  body 
to  study  that  region.  If  we  are  buying  a  farm,  we  are 
not  content  with  the  State  map  or  a  geological  chart 
including  the  estate  in  question.  We  demand  an 
exact  survey  of  that  particular  property,  so  that  we 
may  know  what  we  are  dealing  with.  This  is  just 
what  regional,  or,  as  it  is  sometimes  called,  surgical 
anatomy,  does  for  the  surgeon  with  reference  to  the 
part  on  which  his  skill  is  to  be  exercised.  It  enables 
him  to  see  with  the  mind's  eye  through  the  opaque  tis- 


224  MEDICAL  ESSAYS. 

sues  down  to  the  bone  on  which  they  lie,  as  if  the  skin 
were  transparent  as  the  cornea,  and  the  organs  it  cov 
ers  translucent  as  the  gelatinous  pulp  of  a  medusa. 

It  is  curious  that  the  Japanese  should  have  antici 
pated  Europe  in  a  kind  of  rude  regional  anatomy.  I 
have  seen  a  manikin  of  Japanese  make  traced  all  over 
with  lines,  and  points  marking  their  intersection.  By 
this  their  doctors  are  guided  in  the  performance  of 
acupuncture,  marking  the  safe  places  to  thrust  in  nee 
dles,  as  we  buoy  out  our  ship-channels,  and  doubtless 
indicating  to  learned  eyes  the  spots  where  incautious 
meddling  had  led  to  those  little  accidents  of  shipwreck 
to  which  patients  are  unfortunately  liable. 

A  change  of  method,  then,  has  given  us  General  and 
Regional  Anatomy.  These,  too,  have  been  worked  so 
thoroughly,  that,  if  not  exhausted,  they  have  at  least 
become  to  a  great  extent  fixed  and  positive  branches 
of  knowledge.  But  the  first  of  them,  General  Anat 
omy,  would  never  have  reached  this  positive  condition 
but  for  the  introduction  of  that  instrument  which  I 
have  mentioned  as  the  second  great  aid  to  modern 
progress. 

This  instrument  is  the  achromatic  microscope.  For 
the  history  of  the  successive  steps  by  which  it  became 
the  effective  scientific  implement  we  now  possess,  I 
must  refer  you  to  the  work  of  Mr.  Quekett,  to  an  ex 
cellent  article  in  the  "  Penny  Cyclopaedia,"  or  to  that 
of  Sir  David  Brewster  in  the  "  Encyclopaedia  Britan- 
nica."  It  is  a  most  interesting  piece  of  scientific  his 
tory,  which  shows  how  the  problem  which  Biot  in  1821 
pronounced  iiisolvable  was  in  the  course  of  a  few  years 
practically  solved,  with  a  success  equal  to  that  which 
Dollond  had  long  before  obtained  with  the  telescope, 
tt  is  enough  for  our  purpose  that  we  are  now  in  pos- 


BOEDER   LINES   IN   MEDICAL    SCIENCE.  225 

session  of  an  instrument  freed  from  all  confusions  and 
illusions,  which  magnifies  a  thousand  diameters,  —  a 
million  times  in  surface,  —  without  serious  distortion 
or  discoloration  of  its  object. 

A  quarter  of  a  century  ago,  or  a  little  more,  an  in 
structor  would  not  have  hesitated  to  put  John  Bell's 
"Anatomy"  and  Bostock's  " Physiology "  into  a  stu 
dent's  hands,  as  good  authority  on  their  respective  sub 
jects.  Let  us  not  be  unjust  to  either  of  these  authors. 
John  Bell  is  the  liveliest  medical  writer  that  I  can  re 
member  who  has  written  since  the  days  of  delightful  old 
Ambroise  Pare*.  His  picturesque  descriptions  and  bold 
figures  are  as  good  now  as  they  ever  were,  and  his  book 
can  never  become  obsolete.  But  listen  to  what  John 
Bell  says  of  the  microscope  :  — 

"  Philosophers  of  the  last  age  had  been  at  infinite 
pains  to  find  the  ultimate  fibre  of  muscles,  thinking  to 
discover  its  properties  in  its  form  ;  but  they  saw  just 
in  proportion  to  the  glasses  which  they  used,  or  to 
their  practice  and  skill  in  that  art,  which  is  now  almost 
forsaken."  a 

Dr.  Bostock's  work,  neglected  as  it  is,  is  one  which 
I  value  very  highly  as  a  really  learned  compilation,  full 
}$.  original  references.  But  Dr.  Bostock  says :  "  Much 
as  the  naturalist  has  been  indebted  to  the  microscope, 
by  bringing  into  view  many  beings  of  which  he  could 
aot  otherwise  have  ascertained  the  existence,  the  physi 
ologist  has  not  yet  derived  any  great  benefit  from  the 
instrument."  6 

These  are  only  specimens  of  the  manner  in  which 
ehe  microscope  and  its  results  were  generally  regarded 
by  the  generation  just  preceding  our  own. 

•  Anal,  and  Phys.  of  the  Human  Body,  L  287. 
6  Physiology,  p.  281. 


226  MEDICAL  ESSAYS. 

I  have  referred  you  to  the  proper  authorities  for  the 
account  of  those  improvements  which  about  the  year 
1830  rendered  the  compound  microscope  an  efficient 
and  trustworthy  instrument.  It  was  now  for  the  first 
time  that  a  true  general  anatomy  became  possible.  As 
early  as  1816  Treviranus  had  attempted  to  resolve  the 
tissues,  of  which  Bichat  had  admitted  no  less  than 
twenty-one,  into  their  simple  microscopic  elements. 
How  could  such  an  attempt  succeed,  Henle  well  asks,a 
at  a  tune  when  the  most  extensively  diffused  of  all  the 
tissues,  the  areolar,  was  not  at  all  understood?  All 
that  method  could  do  had  been  accomplished  by  Bichat 
and  his  followers.  It  was  for  the  optician  to  take  the 
next  step.  The  future  of  anatomy  and  physiology,  as 
an  enthusiastic  micrologist  of  the  time  said,  was  in  the 
hands  of  Messrs.  Schieck  and  Pistor,  famous  opticians 
of  Berlin. 

In  those  earlier  days  of  which  I  am  speaking,  all  the 
points  of  minute  anatomy  were  involved  in  obscurity. 
Some  found  globules  everywhere,  some  fibres.  Stu 
dents  disputed  whether  the  conjunctiva  extended  over 
the  cornea  or  not,  and  worried  themselves  over  Gaul- 
tier  de  Claubry's  stratified  layers  of  the  skin,  or  Bres- 
chet's  blennogenous  and  chromatogenous  organs.  The 
dartos  was  a  puzzle,  the  central  spinal  canal  a  myth, 
the  decidua  clothed  in  fable  as  much  as  the  golden 
fleece.  The  structure  of  bone,  now  so  beautifully  made 
out,  —  even  that  of  the  teeth,  in  which  old  Leeuwen- 
hoek,  peeping  with  his  octogenarian  eyes  through  the 
minute  lenses  wrought  with  his  own  hands,  had  long 
ago  seen  the  "  pipes,"  as  he  called  them,  —  was  hardly 
known  at  all.  The  minute  structure  of  the  viscera  lay 
in  the  mists  of  an  uncertain  microscopic  vision.  The 
0  Anatomic  Generate  (Trad,  de  Jourdan),  L  125. 


BORDER   LINES   IN   MEDICAL   SCIENCE.  227 

intimate  recesses  of  the  animal  system  were  to  the 
students  of  anatomy  what  the  interior  of  Africa  long 
was  to  geographers,  and  the  stories  of  microscopic  ex 
plorers  were  as  much  sneered  at  as  those  of  Bruce  or 
Du  Chaillu,  and  with  better  reason. 

Now  what  have  we  come  to  in  our  own  day  ?  In  the 
first  place,  the  minute  structure  of  all  the  organs  has 
been  made  out  in  the  most  satisfactory  way.  The 
special  arrangements  of  the  vessels  and  the  ducts  of 
all  the  glands,  of  the  air-tubes  and  vesicles  of  the  lungs, 
of  the  parts  which  make  up  the  skin  and  other  mem 
branes,  all  the  details  of  those  complex  parenchyma- 
tous  organs  which  had  confounded  investigation  so  long, 
have  been  lifted  out  of  the  invisible  into  the  sight  of 
all  observers.  It  is  fair  to  mention  here,  that  we  owe 
a  great  deal  to  the  art  of  minute  injection,  by  which 
we  are  enabled  to  trace  the  smallest  vessels  in  the  midst 
of  the  tissues  where  they  are  distributed.  This  is  an 
old  artifice  of  anatomists.  The  famous  Ruysch,  who 
died  a  hundred  and  thirty  years  ago,  showed  that  each 
of  the  viscera  has  its  terminal  vessels  arranged  in  its 
own  peculiar  way ;  °  the  same  fact  which  you  may  see 
illustrated  in  Gerber's  figures  after  the  minute  injec 
tions  of  Berres.6  I  hope  to  show  you  many  specimens 
of  this  kind  in  the  microscope,  the  work  of  English 
and  American  hands.  Professor  Agassiz  allows  me 
also  to  make  use  of  a  very  rich  collection  of  injected 
preparations  sent  him  by  Professor  Hyrtl,  formerly  of 
Prague,  now  of  Vienna,  for  the  proper  exhibition  of 
which  I  had  a  number  of  microscopes  made  expressly, 
by  Mr.  Grunow,  during  the  past  season.  All  this  il 
lustrates  what  has  been  done  for  the  elucidation  of  the 
intimate  details  of  formation  of  the  organs. 

•  Haller,  Bibl.  Anat.  i.  533. 

*  General  and  Minute  Anatomy  (London,  1842),  Plate  XXIU 


228  MEDICAL  ESSAYS. 

But  the  great  triumph  of  the  microscope  as  applied 
to  anatomy  has  been  in  the  resolution  of  the  organs 
and  the  tissues  into  their  simple  constituent  anatomical 
elements.  It  has  taken  up  general  anatomy  where 
Bichat  left  it.  He  had  succeeded  in  reducing  the 
structural  language  of  nature  to  syllables,  if  you  will 
permit  me  to  use  so  bold  an  image.  The  microscopic 
observers  who  have  come  after  him  have  analyzed  these 
into  letters,  as  we  may  call  them,  —  the  simple  ele 
ments  by  the  combination  of  which  Nature  spells  out 
successively  tissues,  which  are  her  syllables,  organs 
which  are  her  words,  systems  which  are  her  chapters, 
and  so  goes  on  from  the  simple  to  the  complex,  until 
she  binds  up  in  one  living  whole  that  wondrous  volume 
of  power  and  wisdom  which  we  call  the  human  body. 

The  alphabet  of  the  organization  is  so  short  and 
simple,  that  I  will  risk  fatiguing  your  attention  by  re 
peating  it,  according  to  the  plan  I  have  long  adopted. 

A.  Cells,  either  floating,  as  in  the  blood,  or  fixed, 
like  those  in  the  cancellated  structure  of  bone,  already 
referred  to.     Very  commonly  they  have  undergone  a 
change  of  figure,  most  frequently  a  flattening  which 
reduces  them  to  scales,  as  in  the  epidermis  and  the 
epithelium. 

B.  Simple,  translucent,  homogeneous  solid,  such  as 
is  found  at  the  back  of  the  cornea,  or  forming  the  in 
tercellular  substance  of  cartilage. 

C.  The  white  fibrous  element,  consisting   of  very 
delicate,  tenacious  threads.      This  is  the  long  staple 
textile  substance  of  the  body.     It  is  to  the  organism 
what  cotton  is  pretended  to  be  to  our  Southern  States. 
It  pervades  the  whole  animal  fabric  as  areolar  tissue, 
which  is  the  universal  packing  and  wrapping  material 
tt  forms  the  ligaments  which  bind  the  whole  frame* 


BORDER   LINES   IN   MEDICAL   SCIENCE.  229 

work  together.  It  furnishes  the  sinews,  which  are  the 
channels  of  power.  It  enfolds  every  muscle.  It  wraps 
the  brain  in  its  hard,  insensible  folds,  and  the  heart  it 
self  beats  in  a  purse  that  is  made  of  it. 

D.  The  yellow  elastic,  fibrous  element,  the  caout 
chouc  of  the  animal  mechanism,  which  pulls  things 
back  into  place,  as  the  india-rubber  band  shuts  the 
door  we  have  opened. 

E.  The   striped   muscular   fibre,  —  the   red   flesh, 
which  shortens  itself  in  obedience  to  the  will,  and  thus 
produces  all  voluntary  active  motion. 

F.  The  unstriped  muscular  fibre,  more  properly  the 
fusiform-cell  fibre,  which   carries  on  the  involuntary 
internal  movements. 

G.  The  nerve-cylinder,  a  glassy  tube,  with  a  pith 
of  some  firmness,  which  conveys  sensation  to  the  brain 
and  the  principle  which  induces  motion  from  it. 

H.  The  nerve-corpuscle,  the  centre  of  nervous  power. 

I.  The  mucous  tissue,  as  Virchow  calls  it,  common 
in  embryonic  structures,  seen  in  the  vitreous  humor  of 
the  adult. 

To  these  add  X,  granules,  of  indeterminate  shape 
and  size,  Y,  for  inorganic  matters,  such  as  the  salts  of 
bone  and  teeth,  and  Z,  to  stand  as  a  symbol  of  the 
fluids,  and  you  have  the  letters  of  what  I  have  ventured 
to  call  the  alphabet  of  the  body. 

But  just  as  in  language  certain  diphthongs  and  syl 
lables  are  frequently  recurring,  so  we  have  in  the  body 
certain  secondary  and  tertiary  combinations,  which  we 
meet  more  frequently  than  the  solitary  elements  of 
which  they  are  composed. 

Thus  A  B,  or  a  collection  of  cells  united  by  simple 
structureless  solid,  is  seen  to  be  extensively  employed 
in  the  body  under  the  name  of  cartilage.  Out  of  this 


230  MEDICAL  ESSAYS. 

the  surfaces  of  the  articulations  and  the  springs  of  the 
breathing  apparatus  are  formed.  But  when  Nature 
came  to  the  buffers  of  the  spinal  column  (interverte- 
bral  disks)  and  the  washers  of  the  joints  (semilunar 
fibro-cartilages  of  the  knee,  etc.),  she  required  more 
tenacity  than  common  cartilage  possessed.  What  did 
she  do  ?  What  does  man  do  in  a  similar  case  of  need  ? 
I  need  hardly  tell  you.  The  mason  lays  his  bricks  in 
simple  mortar.  But  the  plasterer  works  some  hair  into 
the  mortar  which  he  is  going  to  lay  in  large  sheets  on 
the  walls.  The  children  of  Israel  complained  that 
they  had  no  straw  to  make  their  bricks  with,  though 
portions  of  it  may  still  be  seen  in  the  crumbling  pyra 
mid  of  Darshour,  which  they  are  said  to  have  built. 
I  visited  the  old  house  on  Witch  Hill  in  Salem  a  year 
or  two  ago,  and  there  I  found  the  walls  coated  with 
clay  in  which  straw  was  abundantly  mingled ;  —  the 
old  Judaizing  witch-hangers  copied  the  Israelites  in  a 
good  many  things.  The  Chinese  and  the  Corsicans 
blend  the  fibres  of  amianthus  in  their  pottery  to  give 
it  tenacity.  Now  to  return  to  Nature.  To  make  her 
buffers  and  washers  hold  together  in  the  shocks  to 
which  they  would  be  subjected,  she  took  common  car 
tilage  and  mingled  the  white  fibrous  tissue  with  it,  to 
serve  the  same  purpose  as  the  hair  in  the  mortar,  the 
straw  in  the  bricks  and  in  the  plaster  of  the  old  wall, 
and  the  amianthus  in  the  earthen  vessels.  Thus  we 
have  the  combination  ABC,  vrfibro-cartilage.  Again, 
the  bones  were  once  only  gristle  or  cartilage,  A  B. 
To  give  them  solidity  they  were  infiltrated  with  stone, 
in  the  form  of  salts  of  lime,  an  inorganic  element, 
so  that  bone  would  be  spelt  out  by  the  letters  A,  B, 
and  Y. 

If  from  these  organic  syllables  we  proceed  to  form 


BORDER   LINES   IN   MEDICAL   SCIENCE.  231 

organic  words,  we  shall  find  that  Nature  employs  three 
principal  forms  ;  namely,  Vessels,  Membranes,  and 
Parenchyma,  or  visceral  tissue.  The  most  complex  of 
them  can  be  resolved  into  a  combination  of  these  few 
simple  anatomical  constituents. 

Passing  for  a  moment  into  the  domain  of  PATHO 
LOGICAL  ANATOMY,  we  find  the  same  elements  in  mor 
bid  growths  that  we  have  met  with  in  normal  struc 
tures.  The  pus-corpuscle  and  the  white  blood-corpuscle 
can  only  be  distinguished  by  tracing  them  to  their 
origin."  A  frequent  form  of  so-called  malignant  dis 
ease  proves  to  be  only  a  collection  of  altered  epithelium- 
cells.  Even  cancer  itself  has  no  specific  anatomical 
element,  and  the  diagnosis  of  a  cancerous  tumor  by 
the  microscope,  though  tolerably  sure  under  the  eye  of 
an  expert,  is  based  upon  accidental,  and  not  essential 
points,  —  the  crowding  together  of  the  elements,  the 
size  of  the  cell-nuclei,  and  similar  variable  characters. 

Let  us  turn  to  PHYSIOLOGY.  The  microscope,  which 
has  made  a  new  science  of  the  intimate  structure  of 
the  organs,  has  at  the  same  time  cleared  up  many  un 
certainties  concerning  the  mechanism  of  the  special 
functions.  Up  to  the  time  of  the  living  generation  of 
observers,  Nature  had  kept  over  all  her  inner  work 
shops  the  forbidding  inscription,  No  Admittance  !  If 
any  prying  observer  ventured  to  spy  through  his  mag 
nifying  tubes  into  the  mysteries  of  her  glands  and 
canals  and  fluids,  she  covered  up  her  work  in  blinding 
mists  and  bewildering  halos,  as  the  deities  of  old  con 
cealed  their  favored  heroes  in  the  moment  of  danger. 

a  "  Quite  impossible  to  distinguish  the  two  structures  from 
each  other  "  (in  certain  cases).  Kolliker,  521. 


232  MEDICAL  ESSAYS. 

Science  has  at  length  sifted  the  turbid  light  of  her 
lenses,  and  blanched  their  delusive  rainbows. 

Anatomy  studies  the  organism  in  space.  Physiol 
ogy  studies  it  also  in  time.  After  the  study  of  form 
and  composition  follows  close  that  of  action,  and  this 
leads  us  along  back  to  the  first  moment  of  the  germ, 
and  forward  to  the  resolution  of  the  living  frame  into 
its  lifeless  elements.  In  this  way  Anatomy,  or  rather 
that  branch  of  it  which  we  call  Histology,  has  become 
inseparably  blended  with  the  study  of  function.  The 
connection  between  the  science  of  life  and  that  of  in 
timate  structure  on  the  one  hand,  and  composition  on 
the  other,  is  illustrated  in  the  titles  of  two  recent  works 
of  remarkable  excellence,  —  "  the  Physiological  Anat 
omy  "  of  Todd  and  Bowman,  and  the  "  Physiological 
Chemistry  "  of  Lehmann. 

Let  me  briefly  recapitulate  a  few  of  our  acquisitions 
in  Physiology,  due  in  large  measure  to  our  new  instru 
ments  and  methods  of  research,  and  at  the  same  time 
indicate  the  limits  which  form  the  permanent  or  the 
temporary  boundaries  of  our  knowledge.  I  will  begin 
with  the  largest  fact  and  with  the  most  absolute  and 
universally  encountered  limitation. 

The  "  largest  truth  in  Physiology  "  Mr.  Paget  con 
siders  to  be  "  the  development  of  ova  through  multi 
plication  and  division  of  their  cells."  I  would  state 
it  more  broadly  as  the  agency  of  the  cell  in  all  living 
processes.  It  seems  at  present  necessary  to  abandon 
the  original  idea  of  Schwann,  that  we  can  observe 
the  building  up  of  a  cell  from  the  simple  granules  of 
a  blastema,  or  formative  fluid.  The  evidence  points 
rather  towards  the  axiom,  Omnis  cellula  e  cellula ; 
that  is,  the  germ  of  a  new  cell  is  always  derived  from 
a  preexisting  cell.  The  doctrine  of  Schwann,  as  I  re- 


BORDER  LINES   IN  MEDICAL   SCIENCE.  233 

marked  long  ago  (1844),  runs  parallel  with  the  nebular 
theory  in  astronomy,  and  they  may  yet  stand  or  fall 
together. 

As  we  have  seen  Nature  anticipating  the  plasterer  in 
fibro-cartilage,  so  we  see  her  beforehand  with  the  glass- 
blower  in  her  dealings  with  the  cell.  The  artisan 
blows  his  vitreous  bubbles,  large  or  small,  to  be  used 
afterwards  as  may  be  wanted.  So  Nature  shapes  her 
hyaline  vesicles  and  modifies  them  to  serve  the  needs 
of  the  part  where  they  are  found.  The  artisan  whirls 
his  rod,  and  his  glass  bubble  becomes  a  flattened  disk, 
with  its  bull's-eye  for  a  nucleus.  These  lips  of  ours  are 
all  glazed  with  microscopic  tiles  formed  of  flattened 
cells,  each  one  of  them  with  its  nucleus  still  as  plain 
and  relatively  as  prominent,  to  the  eye  of  the  micro- 
scopist,  as  the  bull's-eye  in  the  old-fashioned  window- 
pane.  Everywhere  we  find  cells,  modified  or  un 
changed.  They  roll  in  inconceivable  multitudes  (five 
millions  and  more  to  the  cubic  millimetre,  according  to 
Vierordt")  as  blood-disks  through  our  vessels.  A 
close-fitting  mail  of  flattened  cells  coats  our  surface 
with  a  panoply  of  imbricated  scales  (more  than  twelve 
thousand  millions,  as  Harting  has  computed6),  as  true 
a  defence  against  our  enemies  as  the  buckler  of  the  ar 
madillo  or  the  carapace  of  the  tortoise  against  theirs. 
The  same  little  protecting  organs  pave  all  the  great 
highways  of  the  interior  system.  Cells,  again,  preside 
over  the  chemical  processes  which  elaborate  the  living 
fluids  ;  they  change  their  form  to  become  the  agents  of 
voluntary  and  involuntary  motion  ;  the  soul  itself  sits 
on  a  throne  of  nucleated  cells,  and  flashes  its  mandates 
through  skeins  of  glassy  filaments  which  once  were 

•  Kblliker,  Manual,  etc.  (London,  1860 ),  p.  518. 

*  Valentin's  Physiology  (Brinton's  Transl.),  p.  IS. 


234  MEDICAL  ESSAYS. 

simple  chains  of  vesicles.  And,  as  if  to  reduce  the 
problem  of  living  force  to  its  simplest  expression,  we 
see  the  yolk  of  a  transparent  egg  dividing  itself  in 
whole  or  in  part,  and  again  dividing  and  subdividing, 
until  it  becomes  a  mass  of  cells,  out  of  which  the  har 
monious  diversity  of  the  organs  arranges  itself,  worm 
or  man,  as  God  has  willed  from  the  beginning. 

This  differentiation  having  been  effected,  each  several 
part  assumes  its  special  office,  having  a  life  of  its  own 
adjusted  to  that  of  other  parts  and  the  whole.  "  Just 
as  a  tree  constitutes  a  mass  arranged  in  a  definite  man 
ner,  in  which,  in  every  single  part,  in  the  leaves  as  in 
the  root,  in  the  trunk  as  in  the  blossom,  cells  are  dis 
covered  to  be  the  ultimate  elements,  so  is  it  also  with 
the  forms  of  animal  life.  Every  animal  presents 
itself  as  a  sum  of  vital  unities,  every  one  of  which 
manifests  all  the  characteristics  of  life."  ° 

The  mechanism  is  as  clear,  as  unquestionable,  as  ab 
solutely  settled  and  universally  accepted,  as  the  order 
of  movement  of  the  heavenly  bodies,  which  we  com 
pute  backward  to  the  days  of  the  observatories  on  the 
plains  of  Shinar,  and  on  the  faith  of  which  we  regulate 
the  movements  of  war  and  trade  by  the  predictions  of 
our  ephemeris. 

The  mechanism,  and  that  is  all.  We  see  the  work 
man  and  the  tools,  but  the  skill  that  guides  the  work 
and  the  power  that  performs  it  are  as  invisible  as  ever, 
I  fear  that  not  every  listener  took  the  significance  of 
those  pregnant  words  in  the  passage  I  quoted  from 
John  Bell,  —  "  (hinking  to  discover  its  properties  in 
its  form.'1''  We  have  discovered  the  working  bee  in 
this  great  hive  of  organization.  We  have  detected  the 
cell  in  the  very  act  of  forming  itself  from  a  nucleus,  of 
•  Virchow,  Cellular  Pathology,  Lect.  I. 


BORDER  LINES   IN   MEDICAL  SCIENCE.  235 

transforming  itself  into  various  tissues,  of  selecting  the 
elements  of  various  secretions.  But  why  one  cell  be 
comes  nerve  and  another  muscle,  why  one  selects  bile 
and  another  fat,  we  can  no  more  pretend  to  tell,  than 
why  one  grape  sucks  out  of  the  soil  the  generous  juice 
which  princes  hoard  in  their  cellars,  and  another  the 
wine  which  it  takes  three  men  to  drink, —  one  to  pour 
it  down,  another  to  swallow  it,  and  a  third  to  hold  him 
while  it  is  going  down.  Certain  analogies  between 
this  selecting  power  and  the  phenomena  of  endosmosis 
in  the  elective  affinities  of  chemistry  we  can  find,  but 
the  problem  of  force  remains  here,  as  everywhere,  un 
solved  and  insolvable. 

Do  we  gain  anything  by  attempting  to  get  rid  of  the 
idea  of  a  special  vital  force  because  we  find  certain 
mutually  convertible  relations  between  forces  in  the 
body  and  out  of  it  ?  I  think  not,  any  more  than  we 
should  gain  by  getting  rid  of  the  idea  and  expression 
Magnetism  because  of  its  correlation  with  electricity. 
We  may  concede  the  unity  of  all  forms  of  force,  but 
we  cannot  overlook  the  fixed  differences  of  its  mani 
festations  according  to  the  conditions  under  which  it 
acts.  It  is  a  mistake,  however,  to  think  the  mystery  is 
greater  in  an  organized  body  than  in  any  other.  We 
see  a  stone  fall  or  a  crystal  form,  and  there  is  nothing 
stranger  left  to  wonder  at,  for  we  have  seen  the  Infi 
nite  in  action. 

Just  so  far  as  we  can  recognize  the  ordinary  modes 
of  operation  of  the  common  forces  of  nature,  —  grav 
ity,  cohesion,  elasticity,  transudation,  chemical  action, 
and  the  rest,  —  we  see  the  so-called  vital  acts  in  the 
light  of  a  larger  range  of  known  facts  and  familiar 
analogies.  Matteucci's  well-remembered  lectures  con 
tain  many  and  striking  examples  of  the  working  of 


MEDICAL  ESSAYS. 

physical  forces  in  physiological  processes.  Wherever 
rigid  experiment  carries  us,  we  are  safe  in  following 
this  lead ;  but  the  moment  we  begin  to  theorize  be 
yond  our  strict  observation,  we  are  in  danger  of  fall 
ing  into  those  mechanical  follies  which  true  science 
has  long  outgrown. 

Recognizing  the  fact,  then,  that  we  have  learned 
nothing  but  the  machinery  of  life,  and  are  no  nearer 
to  its  essence,  what  is  it  that  we  have  gained  by  this 
great  discovery  of  the  cell  formation  and  function  ? 

It  would  have  been  reward  enough  to  learn  the 
method  Nature  pursues  for  its  own  sake.  If  the  sov 
ereign  Artificer  lets  us  into  his  own  laboratories  and 
workshops,  we  need  not  ask  more  than  the  privilege 
of  looking  on  at  his  work.  We  do  not  know  where 
we  now  stand  in  the  hierarchy  of  created  intelligences. 
We  were  made  a  little  lower  than  the  angels.  I  speak 
it  not  irreverently  ;  as  the  lower  animals  surpass  man 
in  some  of  their  attributes,  so  it  may  be  that  not  every 
angel's  eye  can  see  as  broadly  and  as  deeply  into  the 
material  works  of  God  as  man  himself,  looking  at  the 
firmament  through  an  equatorial  of  fifteen  inches'  ap 
erture,  and  searching  into  the  tissues  with  a  twelfth  of 
an  inch  objective. 

But  there  are  other  positive  gains  of  a  more  practi 
cal  character.  Thus  we  are  no  longer  permitted  to 
place  the  seat  of  the  living  actions  in  the  extreme  ves 
sels,  which  are  only  the  carriers  from  which  each  part 
takes  what  it  wants  by  the  divine  right  of  the  omnipo 
tent  nucleated  cell.  The  organism  has  become,  in  the 
words  already  borrowed  from  Virchow,  "a  sum  of 
vital  unities."  The  strictum  and  laxum,  the  increased 
and  diminished  action  of  the  vessels,  out  of  which 
medical  theories  and  methods  of  treatment  have  grown 


BORDEE  LINES   IN  MEDICAL  SCIENCE.  237 

np,  have  yielded  to  the  doctrine  of  local  cell-communi 
ties,  belonging  to  this  or  that  vascular  district,  from 
which  they  help  themselves,  as  contractors  are  wont  to 
do  from  the  national  treasury. 

I  cannot  promise  to  do  more  than  to  select  a  few  of 
the  points  of  contact  between  our  ignorance  and  our 
knowledge  which  present  particular  interest  in  the  ex 
isting  state  of  our  physiological  acquisitions.  Some  of 
them  involve  the  microscopic  discoveries  of  which  I 
have  been  speaking,  some  belong  to  the  domain  of 
chemistry,  and  some  have  relations  with  other  depart 
ments  of  physical  science. 

If  we  should  begin  with  the  digestive  function,  we 
should  find  that  the  long-agitated  question  of  the  na 
ture  of  the  acid  of  the  gastric  juice  is  becoming  settled 
in  favor  of  the  lactic.  But  the  whole  solvent  agency 
of  the  digestive  fluid  enters  into  the  category  of  that 
exceptional  mode  of  action  already  familiar  to  us  in 
chemistry  as  catalysis.  It  is  therefore  doubly  difficult 
of  explanation ;  first,  as  being,  like  all  reactions,  a  fact 
not  to  be  accounted  for  except  by  the  imaginative  ap 
peal  to  "  affinity,"  and  secondly,  as  being  one  of  those 
peculiar  reactions  provoked  by  an  element  which 
stands  outside  and  looks  on  without  compromising  it 
self. 

The  doctrine  of  Mulder,  so  widely  diffused  in  popu 
lar  and  scientific  belief,  of  the  existence  of  a  common 
base  of  all  albuminous  substances,  the  so-called  pro 
tein,  has  not  stood  the  test  of  rigorous  analysis.  The 
division  of  food  into  azotized  and  non-azotized  is  no 
doubt  important,  but  the  attempt  to  show  that  the  first 
only  is  plastic  or  nutritive,  while  the  second  is  simply 
calorifacient,  or  heat-producing,  fails  entirely  in  the 
face  of  the  facts  revealed  by  the  study  of  man  in  dif 


238  MEDICAL  ESSAYS. 

ferent  climates,  and  of  numerous  experiments  in  the 
feeding  of  animals.  I  must  return  to  this  subject  in 
connection  with  the  respiratory  function. 

The  sugar-making  faculty  of  the  liver  is  another 
"  catalytic  "  mystery,  as  great  as  the  rest  of  them,  and 
no  greater.  Liver-tissue  brings  sugar  out  of  the 
blood,  or  out  of  its  own  substance ;  —  why? 

Quia  est  in  eo 
Virtus  saccharitiva. 

Just  what  becomes  of  the  sugar  beyond  the  fact  of  its 
disappearance  before  it  can  get  into  the  general  circu 
lation  and  sweeten  our  tempers,  it  is  hard  to  say. 

The  pancreatic  fluid  makes  an  emulsion  of  the  fat 
contained  in  our  food,  but  just  how  the  fatty  particles 
get  into  the  villi  we  must  leave  Briicke  and  Kb'Uiker 
to  settle  if  they  can. 

No  one  has  shown  satisfactorily  the  process  by  which 
the  blood-corpuscles  are  formed  out  of  the  lymph-cor 
puscles,  nor  what  becomes  of  them.  These  two  ques 
tions  are  like  those  famous  household  puzzles,  — Where 
do  the  flies  come  from  ?  and,  Where  do  the  pins  go  to  ? 

There  is  a  series  of  organs  in  the  body  which  has 
long  puzzled  physiologists,  —  organs  of  glandular  as 
pect,  but  having  no  ducts,  —  the  spleen,  the  thyroid 
and  thymus  bodies,  and  the  suprarenal  capsules.  We 
call  them  vascular  glands,  and  we  believe  that  they 
elaborate  colored  and  uncolored  blood-cells ;  but  just 
what  changes  they  effect,  and  just  how  they  effect 
them,  it  has  proved  a  very  difficult  matter  to  deter 
mine.  So  of  the  noted  glandules  which  form  Peyer's 
patches,  their  precise  office,  though  seemingly  like 
those  of  the  lymphatic  glands,  cannot  be  positively  as 
signed,  so  far  as  I  know,  at  the  present  time.  It  is  of 


BORDER   LINES   IN   MEDICAL    SCIENCE.  239 

obvious  interest  to  learn  it  with  reference  to  the  pa- 
thology  of  typhoid  fever.  It  will  be  remarked  that  the 
coincidence  of  their  changes  in  this  disease  with  en 
largement  of  the  spleen  suggests  the  idea  of  a  similar 
ity  of  function  in  these  two  organs. 

The  theories  of  the  production  of  animal  heat,  from 
the  times  of  Black,  Lavoisier,  and  Crawford  to  those 
of  Liebig,  are  familiar  to  all  who  have  paid  any  atten 
tion  to  physiological  studies.  The  simplicity  of  Lie- 
big's  views,  and  the  popular  form  in  which  they  have 
been  presented,  have  given  them  wide  currency,  and 
incorporated  them  in  the  common  belief  and  language 
of  our  text-books.  Direct  oxidation  or  combustion  of 
the  carbon  and  hydrogen  contained  in  the  food,  or  in 
the  tissues  themselves  ;  the  division  of  alimentary  sub 
stances  into  respiratory,  or  non-azotized,  and  azotized, 
—  these  doctrines  are  familiar  even  to  the  classes  in 
our  high-schools.  But  this  simple  statement  is  boldly 
questioned.  Nothing  proves  that  oxygen  combines  (in 
the  system)  with  hydrogen  and  carbon  in  particular, 
rather  than  with  sulphur  and  azote.  Such  is  the  well- 
grounded  statement  of  Robin  and  Verdeil.  "  It  is 
very  probable  that  animal  heat  is  entirely  produced 
by  the  chemical  actions  which  take  place  in  the  organ 
ism,  but  the  phenomenon  is  too  complex  to  admit  of 
our  calculating  it  according  to  the  quality  of  oxygen 
consumed."  These  last  are  the  words  of  Regnault,  as 
cited  by  Mr.  Lewes,  whose  intelligent  discussion  of 
this  and  many  of  the  most  interesting  physiological 
problems  I  strongly  recommend  to  your  attention. 

This  single  illustration  covers  a  wider  ground  than 
the  special  function  to  which  it  belongs.  We  are 
learning  that  the  chemistry  of  the  body  must  be 
studied,  not  simply  by  its  ingesta  and  egesta,  but  that 


240  MEDICAL  ESSAYS. 

there  is  a  long  intermediate  series  of  changes  which 
must  be  investigated  in  their  own  light,  under  their 
own  special  conditions.  The  expression  "  sum  of  vital 
unities  "  applies  to  the  chemical  actions,  as  well  as  to 
other  actions  localized  in  special  parts ;  and  when  the 
distinguished  chemists  whom  I  have  just  cited  entitle 
their  work  a  treatise  on  the  immediate  principles  of 
the  body,  they  only  indicate  the  nature  of  that  pro 
found  and  subtile  analysis  which  must  take  the  place 
of  all  hasty  generalizations  founded  on  a  comparison 
of  the  food  with  residual  products. 

I  will  only  call  your  attention  to  the  fact,  that  the 
exceptional  phenomenon  of  the  laboratory  is  the  pre 
vailing  law  of  the  organism.  Nutrition  itself  is  but 
one  great  catalytic  process.  As  the  blood  travels  its 
rounds,  each  part  selects  its  appropriate  element  and 
transforms  it  to  its  own  likeness.  Whether  the  ap 
propriating  agent  be  cell  or  nucleus,  or  a  structureless 
solid  like  the  intercellular  substance  of  cartilage,  the 
fact  of  its  presence  determines  the  separation  of  its 
proper  constituents  from  the  circulating  fluid,  so  that 
even  when  we  are  wounded  bone  is  replaced  by  bone, 
skin  by  skin,  and  nerve  by  nerve. 

It  is  hardly  without  a  smile  that  we  resuscitate  the 
old  question  of  the  vis  insita  of  the  muscular  fibre,  so 
famous  in  the  discussions  of  Haller  and  his  contempo 
raries.  Speaking  generally,  I  think  we  may  say  that 
Haller's  doctrine  is  the  one  now  commonly  received ; 
namely,  that  the  muscles  contract  in  virtue  of  their 
own  inherent  endowments.  It  is  true  that  Kolliker 
says  no  perfectly  decisive  fact  has  been  brought  for 
ward  to  prove  that  the  striated  muscles  contract  with 
out  having  been  acted  on  by  nerves.  Yet  Mr.  Bow 
man's  observations  on  the  contraction  of  isolated  fibres 


BORDER  LINES  IN  MEDICAL   SCIENCE.  241 

appear  decisive  enough  (unless  we  consider  them  in 
validated  by  Dr.  Lionel  Beale's  recent  researches, 
tending  to  show  that  each  elementary  fibre  is  supplied 
with  nerves  °)  ;  and  as  to  the  smooth  muscular  fibres, 
we  have  Virchow's  statement  respecting  the  contractil 
ity  of  those  of  the  umbilical  cord,  where  there  is  not  a 
trace  of  any  nerves.6 

In  the  investigation  of  the  nervous  system,  anatomy 
and  physiology  have  gone  hand  in  hand.  It  is  very 
singular  that  so  important,  and  seemingly  simple,  a 
fact  as  the  connection  of  the  nerve -tubes,  at  their  ori 
gin  or  in  their  course,  with  the  nerve-cells,  should  have 
so  long  remained  open  to  doubt,  as  you  may  see  that 
it  did  by  referring  to  the  very  complete  work  of 
Sharpey  and  Quain  (edition  of  1849),  the  histologi- 
cal  portion  of  which  is  cordially  approved  by  Kolliker 
himself." 

Several  most  interesting  points  of  the  minute  anat 
omy  of  the  nervous  centres  have  been  laboriously  and 
skilfully  worked  out  by  a  recent  graduate  of  this  Med 
ical  School,  in  a  monograph  worthy  to  stand  in  line 
with  those  of  Lockhart  Clarke,  Stilling,  and  Schroder 
van  der  Kolk.d  I  have  had  the  privilege  of  examining 

•  Proc.  Royal  Society,  No.  XL.  vol.  x.,  and  British  and  Foreign 
Med.  Chir.  Review  for  April,  1861. 

4  See  also  the  results  of  experiments  with  woorara  and  sulpho- 
cyanide  of  potassium.  The  first  destroys  the  irritability  of  the 
nerves,  the  second  that  of  the  muscles.  The  student  will  find 
a  notice  of  Bernard's  experiments  with  these  poisons  in  Dr.  Dai- 
ton's  standard  work  on  Physiology,  which,  if  he  does  not  own, 
he  should  at  once  procure. 

*  See  also  a  learned  note  in  Dr.  Waldo  I.  Burnett's  "Reviews 
and  Abstracts,"  etc.,  American  Journal  of  Science,  September, 
1853. 

-  Microscopic  Anatomy  of  the  Lumbar  Enlargement  of  the  Spinal 
Cord.     By  John  Dean,  M.  D.     Cambridge,  1861. 


242  MEDICAL  ESSAYS. 

and  of  showing  some  of  you  a  number  of  Dr.  Dean's 
skilful  preparations.  I  have  no  space  to  give  even  an 
abstract  of  his  conclusions.  I  can  only  refer  to  his 
proof  of  the  fact,  that  a  single  cell  may  send  its  proc 
esses  into  several  different  bundles  of  nerve-roots  (Fig. 
7,  jZ?),  and  to  his  demonstration  of  the  curved  ascend 
ing  and  descending  fibres  from  the  posterior  nerve- 
roots,  to  reach  what  he  has  called  the  longitudinal 
columns  of  the  cornua  (Fig.  8,  h,  Ji).  I  must  also 
mention  Dr.  Dean's  exquisite  microscopic  photographs 
from  sections  of  the  medulla  oblongata,  which  appear 
to  me  to  promise  a  new  development,  if  not  a  new 
epoch,  in  anatomical  art. 

It  having  been  settled  that  the  nerve-tubes  can  very 
commonly  be  traced  directly  to  the  nerve-cells,  the 
object  of  all  the  observers  in  this  department  of  anat 
omy  is  to  follow  these  tubes  to  their  origin.  We  have 
an  infinite  snarl  of  telegraph  wires,  and  we  may  be 
reasonably  sure,  that,  if  we  can  follow  them  up,  we 
shall  find  each  of  them  ends  in  a  battery  somewhere. 
One  of  the  most  interesting  problems  is  to  find  the 
ganglionic  origin  of  the  great  nerves  of  the  medulla 
oblongata,  and  this  is  the  end  to  which,  by  the  aid  of 
the  most  delicate  sections,  colored  so  as  to  bring  out 
their  details,  mounted  so  as  to  be  imperishable,  mag 
nified  by  the  best  instruments,  and  now  self-recorded 
in  the  light  of  the  truth-telling  sunbeam,  our  fellow- 
student  is  making  a  steady  progress  in  a  labor  which  I 
think  bids  fair  to  rank  with  the  most  valuable  contri 
butions  to  histology  that  we  have  had  from  this  side 
of  the  Atlantic. 

It  is  interesting  to  see  how  old  questions  are  inci 
dentally  settled  in  the  course  of  these  new  investiga 
tions.  Thus,  Mr.  Clarke's  dissections,  confirmed  by 


BORDEE  LINES   IN  MEDICAL   SCIENCE.  243 

preparations  of  Mr.  Dean's  which  I  have  myself  ex 
amined,  placed  the  fact  of  the  decussation  of  the  pyra 
mids  —  denied  by  Haller,  by  Morgagni,  and  even  by 
Stilling  —  beyond  doubt.  So  the  spinal  canal,  the  ex 
istence  of  which,  at  least  in  the  adult,  has  been  so  often 
disputed,  appears  as  a  coarse  and  unequivocal  anatomi 
cal  fact  in  many  of  the  preparations  referred  to. 

While  these  studies  of  the  structure  of  the  cord  have 
been  going  on,  the  ingenious  and  indefatigable  Brown- 
Se'quard  has  been  investigating  the  functions  of  its 
different  parts  with  equal  diligence.  The  microscopic 
anatomists  had  shown  that  the  ganglionic  corpuscles 
of  the  gray  matter  of  the  cord  are  connected  with  each 
other  by  their  processes,  as  well  as  with  the  nerve-roots. 
M.  Brown-Se"quard  has  proved  by  numerous  experi 
ments  that  the  gray  substance  transmits  sensitive 
impressions  and  muscular  stimulation.  The  oblique 
ascending  and  descending  fibres  from  the  posterior 
nerve-roots,  joining  the  "  longitudinal  columns  of  the 
cornua,"  a  account  for  the  results  of  Brown-Se'quard's 
sections  of  the  posterior  columns.6  The  physiological 
experimenter  has  also  made  it  evident  that  the  decus 
sation  of  the  conductors  of  sensitive  impressions  has 
its  seat  in  the  spinal  cord,  and  not  in  the  encephalon, 
as  had  been  supposed.  Not  less  remarkable  than  these 
results  are  the  facts,  which  I  with  others  of  my  audi 
ence  have  had  the  opportunity  of  observing,  as  shown 
by  M.  Brown-Se'quard,  of  the  artificial  production  of 
epilepsy  in  animals  by  injuring  the  spinal  cord,  and 
the  induction  of  the  paroxysm  by  pinching  a  certain 
portion  of  the  skin.  I  would  also  call  the  student's 

•  Dean's  Memoir,  Fig.  8. 

*  Lectures  (Philadelphia,  1860),  Lect.  H.  p  26,  and  Plate  I 
fig.  7. 


244  MEDICAL  ESSAYS. 

attention  to  his  account  of  the  relations  of  the  nervous 
centres  to  nutrition  and  secretion,  the  last  of  which 
relations  has  been  made  the  subject  of  an  extended  es 
say  by  our  fellow  countryman,  Dr.  H.  F.  Campbell  of 
Georgia. 

The  physiology  of  the  spinal  cord  seems  a  simple 
matter  as  you  study  it  in  Longet.  The  experiments  of 
Brown-Sdquard  have  shown  the  problem  to  be  a  com 
plex  one,  and  raised  almost  as  many  doubts  as  they 
have  solved  questions ;  at  any  rate,  I  believe  all  lec 
turers  on  physiology  agree  that  there  is  no  part  of 
their  task  they  dread  so  much  as  the  analysis  of  the 
evidence  relating  to  the  special  offices  of  the  different 
portions  of  the  medulla  spinalis.  In  the  brain  we  are 
sure  that  we  do  not  know  how  to  localize  functions  ;  in 
the  spinal  cord,  we  think  we  do  know  something ;  but 
there  are  so  many  anomalies,  and  seeming  contradic 
tions,  and  sources  of  fallacy,  that  beyond  the  facts  of 
crossed  paralysis  of  sensation,  and  the  conducting 
agency  of  the  gray  substance,  I  am  afraid  we  retain 
no  cardinal  principles  discovered  since  the  development 
of  the  reflex  function  took  its  place  by  Sir  Charles 
Bell's  great  discovery. 

By  the  manner  in  which  I  spoke  of  the  brain,  you 
will  see  that  I  am  obliged  to  leave  phrenology  sw5 
Jove,  —  out  in  the  cold,  —  as  not  one  of  the  household 
of  science.  I  am  not  one  of  its  haters ;  on  the  contrary, 
I  am  grateful  for  the  incidental  good  it  has  done.  I 
love  to  amuse  myself  in  its  plaster  Golgothas,  and  lis 
ten  to  the  glib  professor,  as  he  discovers  by  his  man 
ipulations 

"  All  that  disgraced  my  betters  met  in  me." 
I  loved  of  old  to  see  square-headed,  heavy-jawed  Spur» 


BORDER   LINES   IN   MEDICAL   SCIENCE.  245 

heim  make  a  brain  flower  out  into  a  corolla  of  marrowy 
filaments,  as  Vieussens  had  done  before  him,  and  to 
hear  the  dry-fibred  but  human-hearted  George  Combe 
teach  good  sense  under  the  disguise  of  his  equivocal 
system.  But  the  pseudo-sciences,  phrenology  and  the 
rest,  seem  to  me  only  appeals  to  weak  minds  and  the 
weak  points  of  strong  ones.  There  is  a  pica  or  false  ap 
petite  in  many  intelligences ;  they  take  to  odd  fancies  in 
place  of  wholesome  truth,  as  girls  gnaw  at  chalk  and 
charcoal.  Phrenology  juggles  with  nature.  It  is  so 
adjusted  as  to  soak  up  all  evidence  that  helps  it,  and 
shed  all  that  harms  it.  It  crawls  forward  in  all  weath* 
ers,  like  Richard  Edgeworth's  hygrometer.  It  does 
not  stand  at  the  boundary  of  our  ignorance,  it  seems  to 
me,  but  is  one  of  the  will-o'-the-wisps  of  its  undisputed 
central  domain  of  bog  and  quicksand.  Yet  I  should 
not  have  devoted  so  many  words  to  it,  did  I  not  recog 
nize  the  light  it  has  thrown  on  human  actions  by  its 
study  of  congenital  organic  tendencies.  Its  maps  of 
the  surface  of  the  head  are,  I  feel  sure,  founded  on  a 
delusion,  but  its  studies  of  individual  character  are 
always  interesting  and  instructive. 

The  "  snapping-turtle  "  strikes  after  its  natural  fash 
ion  when   it  first  comes   out  of  the  egg.      Children 
betray  their  tendencies  in  their  way  of  dealing  with 
the  breasts  that  nourish  them ;  nay,  I  can  venture  to 
affirm,  that  long  before  they  are  born  they  teach  their 
mothers  something  of  their  turbulent  or  quiet  tempers. 
"  Castor  gaudet  equis,  ovo  prognatus  eodem 
Pugnis." 

Strike  out  the  false  pretensions  of  phrenology ;  call  it 
anthropology ;  let  it  study  man  the  individual  in  dis 
tinction  from  man  the  abstraction,  the  metaphysical  or 
theological  lay-figure;  and  it  becomes  "the  proper 


246  MEDICAL   ESSAYS. 

study  of  mankind,"  one  of  the  noblest  and  most  inter* 
esting  of  pursuits. 

The  whole  physiology  of  the  nervous  system,  from 
the  simplest  manifestation  of  its  power  in  an  insect  up 
to  the  supreme  act  of  the  human  intelligence  working 
through  the  brain,  is  full  of  the  most  difficult  yet  pro 
foundly  interesting  questions.  The  singular  relations 
between  electricity  and  nerve-force,  —  relations  which 
it  has  been  attempted  to  interpret  as  meaning  identity, 
in  the  face  of  palpable  differences,  require  still  more 
extended  studies.  You  may  be  interested  by  Professor 
Faraday's  statement  of  his  opinion  on  the  matter. 
"  Though  I  am  not  satisfied  that  the  nervous  fluid  is 
only  electricity,  still  I  think  that  the  agent  in  the  ner 
vous  system  may  be  an  inorganic  force ;  and  if  there 
be  reason  for  supposing  that  magnetism  is  a  higher 
relation  of  force  than  electricity,  so  it  may  well  be  im 
agined  that  the  nervous  power  may  be  of  a  still  more 
exalted  character,  and  yet  within  the  reach  of  experi 
ment." 

In  connection  with  this  statement,  it  is  interesting  to 
refer  to  the  experiments  of  Helmholtz  on  the  rapidity 
of  transmission  of  the  nervous  actions.  The  rate  is 
given  differently  in  Valentin's  report  of  these  experi 
ments  and  in  that  found  in  the  "  Scientific  Annual " 
for  1858.  One  hundred  and  eighty  to  three  hundred 
feet  per  second  is  the  rate  of  movement  assigned  for 
sensation,  but  all  such  results  must  be  very  vaguely 
approximative.  Boxers,  fencers,  players  at  the  Italian 
game  of  mora,  "  prestidigitators,"  and  all  who  depend 
for  their  success  on  rapidity  of  motion,  know  what  dif 
ferences  there  are  in  the  personal  equation  of  move 
ment. 

Reflex  action,  the  mechanical  sympathy,  if  I  may  so 


BORDER   LINES   IN  MEDICAL   SCIENCE.  247 

call  it,  of  distant  parts  ;  Instinct,  which  is  crystallized 
intelligence,  —  an  absolute  law  with  its  invariable 
planes  and  angles  introduced  into  the  sphere  of  con 
sciousness,  as  raphides  are  inclosed  in  the  living  cells 
of  plants  ;  Intellect,  —  the  operation  of  the  thinking 
principle  through  material  organs,  with  an  appreciable 
waste  of  tissue  in  every  act  of  thought,  so  that  our 
clergymen's  blood  has  more  phosphates  to  get  rid  of 
on  Monday  than  on  any  other  day  of  the  week ;  Will, 
—  theoretically  the  absolute  determining  power,  prac 
tically  limited  in  different  degrees  by  the  varying 
organization  of  races  and  individuals,  annulled  or  per 
verted  by  different  ill-understood  organic  changes ;  — 
on  all  these  subjects  our  knowledge  is  in  its  infancy, 
and  from  the  study  of  some  of  them  the  interdict  of  the 
Vatican  is  hardly  yet  removed. 

I  must  allude  to  one  or  two  points  in  the  histology 
and  physiology  of  the  organs  of  sense.  The  anterior 
continuation  of  the  retina  beyond  the  ora  serrata  has 
been  a  subject  of  much  discussion.  If  H.  Miiller  and 
Kolliker  can  be  relied  upon,  this  question  is  settled  by 
recognizing  that  a  layer  of  cells,  continued  from  the 
retina,  passes  over  the  surface  of  the  zonula  Zinnii,  but 
that  no  proper  nervous  element  is  so  prolonged  for 
ward. 

I  observe  that  Kolliker  calls  the  true  nervous  ele 
ments  of  the  retina  "  the  layer  of  gray  cerebral  sub 
stance."  In  fact,  the  ganglionic  corpuscles  of  each  eye 
may  be  considered  as  constituting  a  little  brain,  con 
nected  with  the  masses  behind  by  the  commissure, 
commonly  called  the  optic  nerve.  We  are  prepared, 
therefore,  to  find  these  two  little  brains  in  the  most 
intimate  relations  with  each  other,  as  we  find  the  cere 
bral  hemispheres.  We  know  that  they  are  directly 


248  MEDICAL  ESSAYS. 

connected  by  fibres  that  arch  round  through  the  chi. 
asma. 

I  mention  these  anatomical  facts  to  introduce  a 
physiological  observation  of  my  own,  first  announced 
in  one  of  the  lectures  before  the  Medical  Class,  subse 
quently  communicated  to  the  American  Academy  of 
Arts  and  Sciences,  and  printed  in  its  "  Transactions  " 
for  February  14,  1860.  I  refer  to  the  apparent  trans 
fer  of  impressions  from  one  retina  to  the  other,  to  which 
I  have  given  the  name  reflex  vision.  The  idea  was 
suggested  to  me  in  consequence  of  certain  effects 
noticed  in  employing  the  stereoscope.  Professor  Wil 
liam  B.  Rodgers  has  since  called  the  attention  of  the 
American  Scientific  Association  to  some  facts  bearing 
on  the  subject,  and  to  a  very  curious  experiment  of 
Leonardo  da  Vinci's,  which  enables  the  observer  to 
look  through  the  palm  of  his  hand  (or  seem  to),  as  if 
it  had  a  hole  bored  through  it.  As  he  and  others  hesi 
tated  to  accept  my  explanation,  I  was  not  sorry  to  find 
recently  the  following  words  in  the  "  Observations  on 
Man "  of  that  acute  observer  and  thinker,  David 
Hartley." 

"  An  impression  made  on  the  right  eye  alone  by  a 
single  object  may  propagate  itself  into  the  left,  and 
there  raise  up  an  image  almost  equal  in  vividness  to 
itself ;  and  consequently  when  we  see  with  one  eye  only, 
we  may,  however,  have  pictures  in  both  eyes."  Hart 
ley,  in  1784,  had  anticipated  many  of  the  doctrines 
which  have  since  been  systematized  into  the  theory  of 
reflex  actions,  and  with  which  I  have  attempted  to  as 
sociate  this  act  of  reflex  vision.  My  sixth  experiment, 
however,  in  the  communication  referred  to,  appears  to 
me  to  be  a  crucial  one,  proving  the  correctness  of  my 
•  Vol.  i.  p.  207.  London,  1801. 


BORDER  LINES  IN  MEDICAL   SCIENCE.  249 

explanation,  and  I  am  not  aware  that  it  has  been  before 
instituted. 

Another  point  of  great  interest  connected  with  the 
physiology  of  vision,  and  involved  for  a  long  time  in 
great  obscurity,  is  that  of  the  adjustment  of  the  eye  to 
different  distances.  Dr.  Clay  Wallace  of  New  York, 
who  published  a  very  ingenious  little  book  on  the  eye 
about  twenty  years  ago,  with  vignettes  reminding  one 
of  Bewick,  was  among  the  first,  if  not  the  first,  to  de 
scribe  the  ciliary  muscle,  to  which  the  power  of  adjust 
ment  is  generally  ascribed.  It  is  ascertained,  by  exact 
experiment  with  the  phacueidoscope,  that  accommoda 
tion  depends  on  change  of  form  of  the  crystalline  lens. 
Where  the  crystalline  is  wanting,  as  Mr.  Ware  long 
ago  taught,  no  power  of  accommodation  remains.  The 
ciliary  muscle  is  generally  thought  to  effect  the  change 
of  form  of  the  crystalline.  The  power  of  accommoda 
tion  is  lost  after  the  application  of  atropine,  in  conse 
quence,  as  is  supposed,  of  the  paralysis  of  this  muscle. 
This,  I  believe,  is  the  nearest  approach  to  a  demonstra 
tion  we  have  on  this  point. 

I  have  only  time  briefly  to  refer  to  Professor  Draper's 
most  ingenious  theory  as  to  the  photographic  nature  of 
vision,  for  an  account  of  which  I  must  refer  to  his 
original  and  interesting  Treatise  on  Physiology. 

It  were  to  be  wished  that  the  elaborate  and  very  in 
teresting  researches  of  the  Marquis  Corti,  which  have 
revealed  such  singular  complexity  of  structure  in  the 
cochlea  of  the  ear,  had  done  more  to  clear  up  its 
doubtful  physiology ;  but  I  am  afraid  we  have  nothing 
but  hypotheses  for  the  special  part  it  plays  in  the  act 
of  hearing,  and  that  we  must  say  the  same  respecting 
the  office  of  the  semicircular  canals. 

The  microscope  has  achieved  some  of  its   greatest 


250  MEDICAL  ESSAYS. 

triumphs  in  teaching  us  the  changes  which  occur  in 
the  development  of  the  embryo.  No  more  interesting 
discovery  stands  recorded  in  the  voluminous  literature 
of  this  subject  than  the  one  originally  announced  by 
Martin  Barry,  afterwards  discredited,  and  still  later 
confirmed  by  Mr.  Newport  and  others;  namely  the 
fact  that  the  fertilizing  filament  reaches  the  interior  of 
the  ovum  in  various  animals ;  —  a  striking  parallel  to 
the  action  of  the  pollen-tube  in  the  vegetable.  But  be 
yond  the  mechanical  facts  all  is  mystery  in  the  move 
ments  of  organization,  as  profound  as  in  the  fall  of  a 
stone  or  the  formation  of  a  crystal. 

To  the  chemist  and  the  microscopist  the  living  body 
presents  the  same  difficulties,  arising  from  the  fact 
that  everything  is  in  perpetual  change  in  the  organ 
ism.  The  fibrine  of  the  blood  puzzles  the  one  as  much 
as  its  globules  puzzle  the  other.  The  difference  be 
tween  the  branches  of  science  which  deal  with  space 
only,  and  those  which  deal  with  space  and  time,  is 
this  :  we  have  no  glasses  that  can  magnify  time.  The 
figure  I  here  show  you0  was  photographed  from  an  ob 
ject  (pleurosigma  angulatum)  magnified  a  thousand 
diameters,  or  presenting  a  million  times  its  natural 
surface.  This  other  figure  of  the  same  object,  en 
larged  from  the  one  just  shown,  is  magnified  seven 
thousand  diameters,  or  forty-nine  million  times  in  sur 
face.  When  we  can  make  the  forty-nine  millionth  of  a 
second  as  long  as  its  integer,  physiology  and  chemistry 
will  approach  nearer  the  completeness  of  anatomy. 

Our  reverence  becomes  more  worthy,  or,  if  you  will, 

•  From  a  very  interesting  paper  by  Professor  O.  N.  Rood  of 
Albany,  containing,  with  other  views,  the  first  microscopic  stereo 
graph  I  have 


BORDER  LINES  IN  MEDICAL  SCIENCE.  251 

less  unworthy  of  its  Infinite  Object  in  proportion  as 
our  intelligence  is  lifted  and  expanded  to  a  higher  and 
broader  understanding  of  the  Divine  methods  of  action. 
If  Galen  called  his  heathen  readers  to  admire  "the 
power,  the  wisdom,  the  providence,  the  goodness  of 
the  Framer  of  the  animal  body,"  —  if  Mr.  Boyle,  the 
student  of  nature,  as  Addison  and  that  friend  of  his 
who  had  known  him  for  forty  years  tell  us,  never  ut 
tered  the  name  of  the  Supreme  Being  without  making 
a  distinct  pause  in  his  speech,  in  token  of  his  devout 
recognition  of  its  awful  meaning,  —  surely  we,  who 
inherit  the  accumulated  wisdom  of  nearly  two  hundred 
years  since  the  time  of  the  British  philosopher,  and  of 
almost  two  thousand  since  the  Greek  physician,  may 
well  lift  our  thoughts  from  the  works  we  study  to  their 
great  Artificer.  These  wonderful  discoveries  which  we 
owe  to  that  mighty  little  instrument,  the  telescope  of 
the  inner  firmament  with  all  its  included  worlds ;  these 
simple  formulas  by  which  we  condense  the  observations 
of  a  generation  in  a  single  axiom ;  these  logical  analy 
ses  by  which  we  fence  out  the  ignorance  we  cannot  re 
claim,  and  fix  the  limits  of  our  knowledge,  —  all  lead 
us  up  to  the  inspiration  of  the  Almighty,  which  gives 
understanding  to  the  world's  great  teachers.  To  fear 
science  or  knowledge,  lest  it  disturb  our  old  beliefs,  is 
to  fear  the  influx  of  the  Divine  wisdom  into  the  souls 
of  our  fellow-men ;  for  what  is  science  but  the  piece 
meal  revelation,  —  uncovering, — of  the  plan  of  crea 
tion,  by  the  agency  of  those  chosen  prophets  of  nature 
whom  God  has  illuminated  from  the  central  light  of 
truth  for  that  single  purpose  ? 

The  studies  which  we  have  glanced  at  are  prelim 
inary  in  your  education  to  the  practical  arts  which 


252  MEDICAL  ESSAYS. 

make  use  of  them, — the  arts  of  healing,  —  surgery  ana 
medicine.  The  more  you  examine  the  structure  of  the 
organs  and  the  laws  of  life,  the  more  you  will  find  how 
resolutely  each  of  the  cell-republics  which  make  up  the 
E  pluribus  unum  of  the  body  maintains  its  independ 
ence.  Guard  it,  feed  it,  air  it,  warm  it,  exercise  or 
rest  it  properly,  and  the  working  elements  will  do  their 
best  to  keep  well  or  to  get  well.  What  do  we  do  with 
ailing  vegetables?  Dr.  Warren,  my  honored  prede 
cessor  in  this  chair,  bought  a  country-place,  including 
half  of  an  old  orchard.  A  few  years  afterwards  I  saw 
the  trees  on  his  side  of  the  fence  looking  in  good 
health,  while  those  on  the  other  side  were  scraggy  and 
miserable.  How  do  you  suppose  this  change  was 
brought  about?  By  watering  them  with  Fowler's 
solution  ?  By  digging  in  calomel  freely  about  their 
roots?  Not  at  all;  but  by  loosening  the  soil  round 
them,  and  supplying  them  with  the  right  kind  of  food 
in  fitting  quantities. 

Now  a  man  is  not  a  plant,  or,  at  least,  he  is  a  very 
curious  one,  for  he  carries  his  soil  in  his  stomach, 
which  is  a  kind  of  portable  flower-pot,  and  he  grows 
round  it,  instead  of  out  of  it.  He  has,  besides,  a  sin 
gularly  complex  nutritive  apparatus  and  a  nervous 
system.  But  recollect  the  doctrine  already  enunciated 
in  the  language  of  Virchow,  that  an  animal,  like  a 
tree,  is  a  sum  of  vital  unities,  of  which  the  cell  is  the 
ultimate  element.  Every  healthy  cell,  whether  in  a 
vegetable  or  an  animal,  necessarily  performs  its  func 
tion  properly  so  long  as  it  is  supplied  with  its  proper 
materials  and  stimuli.  A  cell  may,  it  is  true,  be  con- 
genitally  defective,  in  which  case  disease  is,  so  to 
speak,  its  normal  state.  But  if  originally  sound  and 
subsequently  diseased,  there  has  certainly  been  some 


BORDER  LINES  IN  MEDICAL  SCIENCE.  253 

excess,  deficiency,  or  wrong  quality  in  the  materials  or 
stimuli  applied  to  it.  You  remove  this  injurious  influ 
ence  and  substitute  a  normal  one ;  remove  the  baked 
coal-ashes,  for  instance,  from  the  roots  of  a  tree,  and 
replace  them  with  loam ;  take  away  the  salt  meat  from 
the  patient's  table,  and  replace  it  with  fresh  meat  and 
vegetables,  and  the  cells  of  the  tree  or  the  man  return 
to  their  duty. 

I  do  not  know  that  we  ever  apply  to  a  plant  any 
element  which  is  not  a  natural  constituent  of  the  vege 
table  structure,  except  perhaps  externally,  for  the  ac 
cidental  purpose  of  killing  parasites.  The  whole  art 
of  cultivation  consists  in  learning  the  proper  food  and 
conditions  of  plants,  and  supplying  them.  We  give 
them  water,  earths,  salts  of  various  kinds  such  as  they 
are  made  of,  with  a  chance  to  help  themselves  to  air 
and  light.  The  farmer  would  be  laughed  at  who  un 
dertook  to  manure  his  fields  or  his  trees  with  a  salt  of 
lead  or  of  arsenic.  These  elements  are  not  constitu 
ents  of  healthy  plants.  The  gardener  uses  the  waste 
of  the  arsenic  furnaces  to  kill  the  weeds  in  his  walks. 

If  the  law  of  the  animal  cell,  and  of  the  animal  or 
ganism,  which  is  built  up  of  such  cells,  is  like  that  of 
the  vegetable,  we  might  expect  that  we  should  treat 
all  morbid  conditions  of  any  of  the  vital  unities  be 
longing  to  an  animal  in  the  same  way,  by  increasing, 
diminishing,  or  changing  its  natural  food  or  stimuli. 

"  That  is  an  aliment  which  nourishes  ;  whatever  we 
find  in  the  organism,  as  a  constant  and  integral  ele 
ment,  either  forming  part  of  its  structure,  or  one  of 
the  conditions  of  vital  processes,  that  and  that  only 
deserves  the  name  of  aliment." a  I  see  no  reason, 
therefore,  why  iron,  phosphate  of  lime,  sulphur,  should 
•  Lewes,  Physiology  of  Common  Life,  i.  76. 


254  MEDICAL  ESSAYS. 

not  be  considered/bod?  for  man,  as  much  as  guano  01 
poudrette  for  vegetables.  Whether  one  or  another  of 
them  is  best  in  any  given  case,  —  whether  they  shall 
be  taken  alone  or  in  combination,  in  large  or  small 
quantities,  —  are  separate  questions.  But  they  are 
elements  belonging  to  the  body,  and  even  in  moderate 
excess  will  produce  little  disturbance.  There  is  no 
presumption  against  any  of  this  class  of  substances, 
any  more  than  against  water  or  salt,  provided  they  are 
used  in  fitting  combinations,  proportions,  and  forms. 

But  when  it  comes  to  substances  alien  to  the  healthy 
system,  which  never  belong  to  it  as  normal  constitu 
ents,  the  case  is  very  different.  There  is  a  presump 
tion  against  putting  lead  or  arsenic  into  the  human 
body,  as  against  putting  them  into  plants,  because  they 
do  not  belong  there,  any  more  than  pounded  glass, 
which,  it  is  said,  used  to  be  given  as  a  poison.  The 
same  thing  is  true  of  mercury  and  silver.  What  be 
comes  of  these  alien  substances  after  they  get  into  the 
system  we  cannot  always  tell.  But  in  the  case  of  sil 
ver,  from  the  accident  of  its  changing  color  under  the 
influence  of  light,  we  do  know  what  happens.  It  is 
thrown  out,  in  part  at  least,  under  the  epidermis,  and 
there  it  remains  to  the  patient's  dying  day.  This  is  a 
striking  illustration  of  the  difficulty  which  the  system 
finds  in  dealing  with  non-assimilable  elements,  and  jus 
tifies  in  some  measure  the  vulgar  prejudice  against 
"  mineral  poisons." 

I  trust  the  youngest  student  on  these  benches  will 
not  commit  the  childish  error  of  confounding  a  pre 
sumption  against  a  particular  class  of  agents  with  a 
condemnation  of  them.  Mercury,  for  instance,  is  alien 
to  the  system,  and  eminently  disturbing  in  its  influ 
ence.  Yet  its  efficacy  in  certain  forms  of  specific  dis~ 


BORDER  LINES   IN  MEDICAL  SCIENCE.  255 

ease  is  acknowledged  by  all  but  the  most  sceptical 
theorists.  Even  the  esprit  moqueur  of  Ricord,  the 
Voltaire  of  pelvic  literature,  submits  to  the  time-hon 
ored  constitutional  authority  of  this  great  panacea  in 
the  class  of  cases  to  which  he  has  devoted  his  brilliant 
intelligence.  Still,  there  is  no  telling  what  evils  have 
arisen  from  the  abuse  of  this  mineral.  Dr.  Armstrong 
long  ago  pointed  out  some  of  them,  and  they  have  be 
come  matters  of  common  notoriety.  I  am  pleased, 
therefore,  when  I  find  so  able  and  experienced  a  prac 
titioner  as  Dr.  Williams  of  this  city  proving  that  iritia 
is  best  treated  without  mercury,"  and  Dr.  Vanderpoel 
showing  the  same  thing  to  be  true  for  pericarditis. 

Whatever  elements  nature  does  not  introduce  into 
vegetables,  the  natural  food  of  all  animal  life,  —  di 
rectly  of  herbivorous,  indirectly  of  carnivorous  ani 
mals,  —  are  to  be  regarded  with  suspicion.  Arsenic- 
eating  may  seem  to  improve  the  condition  of  horses 
for  a  time,  —  and  even  of  human  beings,  if  Tschudi's 
stories  can  be  trusted,  —  but  it  soon  appears  that  its 
alien  qualities  are  at  war  with  the  animal  organization. 
So  of  copper,  antimony,  and  other  non-alimentary  sim 
ple  substances ;  every  one  of  them  is  an  intruder  in 
the  living  system,  as  much  as  a  constable  would  be, 
quartered  in  our  household.  This  does  not  mean  that 
they  may  not,  any  of  them,  be  called  in  for  a  special 
need,  as  we  send  for  the  constable  when  we  have  good 
reason  to  think  we  have  a  thief  under  our  roof ;  but  a 
man's  body  is  his  castle,  as  well  as  his  house,  and  the 
presumption  is  that  we  are  to  keep  our  alimentary 
doors  bolted  against  these  perturbing  agents. 

Now  the  feeling  is  very  apt  to  be  just  contrary  to 
this.  The  habit  has  been  very  general  with  well 

•  On  the  Treatment  of  Iritis  without  Mercury,  Boston,  1856. 


256  MEDICAL  ESSAYS. 

taught  practitioners,  to  have  recourse  to  the  introduc 
tion  of  these  alien  elements  into  the  system  on  the 
occasion  of  any  slight  disturbance.  The  tongue  was  a 
little  coated,  and  mercury  must  be  given ;  the  skin  was 
a  little  dry,  and  the  patient  must  take  antimony.  It 
was  like  sending  for  the  constable  and  the  posse  comi- 
tatus  when  there  is  only  a  carpet  to  shake  or  a  refuse- 
barrel  to  empty."  The  constitution  bears  slow  poisoning 
a  great  deal  better  than  might  be  expected ;  yet  the 
most  intelligent  men  in  the  profession  have  gradually 
got  out  of  the  habit  of  prescribing  these  powerful  alien 
substances  in  the  old  routine  way.  Mr.  Metcalf  will 
tell  you  how  much  more  sparingly  they  are  given  by 
our  practitioners  at  the  present  time,  than  when  he  first 
inaugurated  the  new  era  of  pharmacy  among  us.  Still, 
the  presumption  in  favor  of  poisoning  out  every  spon 
taneous  reaction  of  outraged  nature  is  not  extinct  in 
those  who  are  trusted  with  the  lives  of  their  fellow- 
citizens.  "  On  examining  the  file  of  prescriptions  at 
the  hospital,  I  discovered  that  they  were  rudely  written, 
and  indicated  a  treatment,  as  they  consisted  chiefly  of 
tartar  emetic,  ipecacuanha,  and  epsom  salts,  hardly 
favorable  to  the  cure  of  the  prevailing  diarrhoea  and 
dysenteries."  b  In  a  report  of  a  poisoning  case  now  on 
trial,  where  we  are  told  that  arsenic  enough  was  found 
in  the  stomach  to  produce  death  in  twenty-four  hours, 
the  patient  is  said  to  have  been  treated  by  arsenic, 

"  Dr.  James  Johnson  advises  persons  not  ailing  to  take  five 
grains  of  blue  pill  with  one  or  two  of  aloes  twice  a  week  for  three 
or  four  months  in  the  year,  with  half  a  pint  of  compound  decoc 
tion  of  sarsaparilla  everyday  for  the  same  period,  to  preserve 
health  and  prolong  life.  Pract.  Treatise  on  Dis.  of  Liver,  etc. 
p.  272. 

*  United  States  Sanitary  Commission,  Document  No.  25.  Re- 
port  on  a  Regiment  near  Washington,  dated  July  9,  1861. 


BORDER  LINES  IN  MEDICAL   SCIENCE.  257 

phosphorus,  bryonia,  aconite,  nux  vomica,  and  muriatic 
acid,  —  by  a  practitioner  of  what  school  it  may  be  im 
agined. 

The  traditional  idea  of  always  poisoning  out  disease, 
as  we  smoke  out  vermin,  is  now  seeking  its  last  refuge 
behind  the  wooden  cannon  and  painted  port-holes  of 
that  unblushing  system  of  false  scientific  pretences 
which  I  do  not  care  to  name  in  a  discourse  addressed 
to  an  audience  devoted  to  the  study  of  the  laws  of  nature 
in  the  light  of  the  laws  of  evidence.  It  is  extraordi 
nary  to  observe  that  the  system  which,  by  its  reducing 
medicine  to  a  name  and  a  farce,  has  accustomed  all 
who  have  sense  enough  to  see  through  its  thin  artifices 
to  the  idea  that  diseases  get  well  without  being  "  cured," 
should  now  be  the  main  support  of  the  tottering  poi 
son-cure  doctrine.  It  has  unquestionably  helped  to 
teach  wise  people  that  nature  heals  most  diseases  with 
out  help  from  pharmaceutic  art,  but  it  continues  to 
persuade  fools  that  art  can  arrest  them  all  with  its 
specifics. 

It  is  worse  than  useless  to  attempt  in  any  way  to 
check  the  freest  expression  of  opinion  as  to  the  efficacy 
of  any  or  all  of  the  "  heroic  "  means  of  treatment  em 
ployed  by  practitioners  of  different  schools  and  periods. 
Medical  experience  is  a  great  thing,  but  we  must  not 
forget  that  there  is  a  higher  experience,  which  tries  its 
results  in  a  court  of  a  still  larger  jurisdiction ;  that, 
namely,  in  which  the  laws  of  human  belief  are  sum 
moned  to  the  witness-box,  and  obliged  to  testify  to  the 
sources  of  error  which  beset  the  medical  practitioner. 
The  verdict  is  as  old  as  the  father  of  medicine,  who 
announces  it  in  the  words,  "judgment  is  difficult." 
Physicians  differed  so  in  his  time,  that  some  denied 
that  there  was  any  such  thing  as  an  art  of  medicine. 


258  MEDICAL  ESSAYS. 

One  man's  best  remedies  were  held  as  mischievous  by 
another.  The  art  of  healing  was  like  soothsaying,  so 
the  common  people  said ;  the  same  bird  was  lucky  or 
unlucky,  according  as  he  flew  to  the  right  or  left.a 

The  practice  of  medicine  has  undergone  great  changes 
within  the  period  of  my  own  observation.  Venesec 
tion,  for  instance,  has  so  far  gone  out  of  fashion,  that, 
as  I  am  told  by  residents  of  the  New  York  Bellevue 
and  the  Massachusetts  General  Hospitals,  it  is  almost 
obsolete  in  these  institutions,  at  least  in  medical  prac 
tice.6  The  old  Brunonian  stimulating  treatment  has 
come  into  vogue  again  in  the  practice  of  Dr.  Todd 
and  his  followers.  The  compounds  of  mercury  have 
yielded  their  place  as  drugs  of  all  work,  and  specifics 
for  that  very  frequent  subjective  complaint,  nescio  quid 
faciam,  — to  compounds  of  iodine.6  Opium  is  believed 
in,  and  quinine,  and  "rum,"  using  that  expressive 
monosyllable  to  mean  all  alcoholic  cordials.  If  Molie're 
were  writing  now,  instead  of  saignare,  purgare,  and 
the  other,  he  would  be  more  like  to  say,  Stimulare, 
opium  dare  et  potassio-iodizare. 

I  have  been  in  relation  successively  with  the  Eng 
lish  and  American  evacuant  and  alterative  practice,  in 
which  calomel  and  antimony  figured  so  largely  that,  as 
you  may  see  in  Dr.  Jackson's  last  "  Letter,"  Dr.  Hoi- 
yoke,  a  good  representative  of  sterling  old-fashioned 

a  Ilepl  Aiafrtjj  'OfeW,  §  IV.  V. 

*  A  similar  change  has  taken  place  also  in  English  surgical 
practice.     Sir  W.  Napier  speaks  of  "  that  inveterate  use  of  the 
lancet,  which  disgraced  the  surgery  of  the  times,"  —  the  early 
years  of  this  century.     Life  and  Opinions  of  Sir  Charles  James 
Napier  (London,  1857),  vol.  i.  p.  158. 

•  Sir  Astley  Cooper  has  the  boldness,  —  or  honesty, —  to  speak 
of  medicines  which  "are  given  as  much  to  assist  the  medica 
man  as  his  patient."    Lectures  (London,  1832),  p.  1-i. 


BORDER  LINES   IN  MEDICAL  SCIENCE.  259 

medical  art,  counted  them  with  opium  and  Peruvian 
bark   as  his  chief  remedies ;  with  the  moderately  ex 
pectant  practice  of  Louis  ;  the  blood-letting  "  coup  sur 
coup"  of  Bouillaud;  the  contra-stimulant  method  of 
Rasori  and  his  followers;  the  anti-irritant  system  of 
Broussais,  with   its   leeching  and  gum-water ;  I  have 
heard  from  our  own  students  of  the  simple  opium  prac 
tice  of  the  renowned  German  teacher,  Oppolzer ;  and 
now  I  find  the  medical  community  brought  round  by 
the  revolving  cycle  of  opinion  to  that  same  old  plan  of 
treatment  which  John  Brown  taught  in  Edinburgh  in 
the  last  quarter  of  the  last  century,  and  Miner  and  Tully 
fiercely  advocated  among  ourselves  in  the  early  years  of 
the  present.   The  worthy  physicians  last  mentioned,  and 
their  antagonist  Dr.  Gallup,  used  stronger  language 
than   we  of   these  degenerate  days   permit  ourselves. 
"  The  lancet  is  a  weapon  which  annually  slays  more 
than  the  sword,"    says   Dr.  Tully.     "It   is  probable 
that,  for  forty  years  past,  opium  and  its  preparations 
have  done  seven  times  the  injury  they  have  rendered 
benefit,  on  the  great  scale  of  the  world,"  says  Dr.  Gallup. 
What  is  the  meaning   of  these  perpetual  changes 
and  conflicts  of  medical  opinion  and  practice,  from  an 
early  antiquity  to  our  own  time  ?     Simply  this :  all 
"  methods "  of  treatment   end   in   disappointment  of 
those  extravagant  expectations  which  men  are  wont  to 
entertain  of  medical  art.     The  bills  of  mortality  are 
more  obviously  affected  by  drainage,  than  by  this  or 
that  method  of  practice.    The  insurance  companies  do 
not  commonly  charge  a  different   percentage  on  the 
lives  of  the  patients  of  this  or  that  physician.     In  the 
course  of  a  generation,  more  or  less,  physicians  them 
selves  are  liable  to  get  tired  of  a  practice  which  has 
so  little  effect  upon  the  average  movement  of  vital 


260  MEDICAL  ESSAYS. 

decomposition.  Then  they  are  ready  for  a  change, 
even  if  it  were  back  again  to  a  method  which  has  al 
ready  been  tried,  and  found  wanting. 

Our  practitioners,  or  many  of  them,  have  got  back 
to  the  ways  of  old  Dr.  Samuel  Danforth,  who,  as  it  is 
well  known,  had  strong  objections  to  the  use  of  the 
lancet.  By  and  by  a  new  reputation  will  be  made  by 
some  discontented  practitioner,  who,  tired  of  seeing 
patients  die  with  their  skins  full  of  whiskey  and  their 
brains  muddy  with  opium,  returns  to  a  bold  antiphlo 
gistic  treatment,  and  has  the  luck  to  see  a  few  patients 
of  note  get  well  under  it.  So  of  the  remedies  which 
have  gone  out  of  fashion  and  been  superseded  by 
others.  It  can  hardly  be  doubted  that  they  will  come 
into  vogue  again,  more  or  less  extensively,  under  the 
influence  of  that  irresistible  demand  for  change  just 
referred  to. 

Then  will  come  the  usual  talk  about  a  change  in  the 
character  of  disease,  which  has  about  as  much  mean 
ing  as  that  concerning  "  old-fashioned  snow-storms." 
"  Epidemic  constitutions  "  of  disease  mean  something, 
no  doubt ;  a  great  deal  as  applied  to  malarious  affec 
tions  ;  but  that  the  whole  type  of  diseases  undergoes 
such  changes  that  the  practice  must  be  reversed  from 
depleting  to  stimulating,  and  vice  versa,  is  much  less 
likely  than  that  methods  of  treatment  go  out  of  fash 
ion  and  come  in  again.  If  there  is  any  disease  which 
claims  its  percentage  with  reasonable  uniformity,  it  is 
phthisis.  Yet  I  remember  that  the  reverend  and  ven 
erable  Dr.  Prince  of  Salem  told  me  one  Commence 
ment  day,  as  1  was  jogging  along  towards  Cambridge 
with  him,  that  he  recollected  the  time  when  that  dis 
ease  was  hardly  known;  and  in  confirmation  of  his 
statement  mentioned  a  case  in  which  it  was  told  as  a 


BORDER   LINES    IN  MEDICAL   SCIENCE.  261 

great  event,  that  somebody  down  on  "  the  Cape  "  had 
died  of  "  a  consumption."  This  story  does  not  sound 
probable  to  myself,  as  I  repeat  it,  yet  I  assure  you  it 
is  true,  and  it  shows  how  cautiously  we  must  receive 
all  popular  stories  of  great  changes  in  the  habits  of 
disease." 

Is  there  no  progress,  then,  but  do  we  return  to  the 
same  beliefs  and  practices  which  our  forefathers  wore 
out  and  threw  away  ?  I  trust  and  believe  that  there 
is  a  real  progress.  We  may,  for  instance,  return  in 
a  measure  to  the  Brunonian  stimulating  system,  but  it 
must  be  in  a  modified  way,  for  we  cannot  go  back  to 
the  simple  Brunonian  pathology,  since  we  have  learned 
too  much  of  diseased  action  to  accept  its  convenient 
dualism.  So  of  other  doctrines,  each  new  Avatar 
strips  them  of  some  of  their  old  pretensions,  until  they 
take  their  fitting  place  at  last,  if  they  have  any  truth 
in  them,  or  disappear,  if  they  were  mere  phantasms 
of  the  imagination. 

In  the  mean  time,  while  medical  theories  are  com 
ing  in  and  going  out,  there  is  a  set  of  sensible  men 
who  are  never  run  away  with  by  them,  but  practise 
their  art  sagaciously  and  faithfully  in  much  the  same 
way  from  generation  to  generation.  From  the  time 
of  Hippocrates  to  that  of  our  own  medical  patriarch, 
there  has  been  an  apostolic  succession  of  wise  and  good 
practitioners.  If  you  will  look  at  the  first  aphorism 
of  the  ancient  Master  you  will  see  that  before  all  rem 
edies  he  places  the  proper  conduct  of  the  patient  and 
his  attendants,  and  the  fit  ordering  of  all  the  condi 
tions  surrounding  him.  The  class  of  practitioners  I 

•  See  Brit,  and  For.  Med.-Chir.  Rev.  for  October,  1860,  p.  239. 
The  last  two  paragraphs  were  in  type  before  I  had  seen  the  ar> 
ticle  here  referred  to. 


262  MEDICAL   ESSAYS. 

have  referred  to  have  always  been  the  most  faithful  in 
attending  to  these  points.  No  doubt  they  have  some 
times  prescribed  unwisely,  in  compliance  with  the 
prejudices  of  their  time,  but  they  have  grown  wiser  as 
they  have  grown  older,  and  learned  to  trust  more  in 
nature  and  less  in  their  plans  of  interference.  I  believe 
common  opinion  confirms  Sir  James  Clark's  observa 
tion  to  this  effect. 

The  experience  of  the  profession  must,  I  think,  run 
parallel  with  that  of  the  wisest  of  its  individual  mem 
bers.  Each  time  a  plan  of  treatment  or  a  particular 
remedy  comes  up  for  trial,  it  is  submitted  to  a  sharper 
scrutiny.  When  Cullen  wrote  his  Materia  Medica,  he 
had  seriously  to  assail  the  practice  of  giving  burnt 
toad,  which  was  still  countenanced  by  at  least  one 
medical  authority  of  note.  I  have  read  recently  in 
some  medical  journal,  that  an  American  practitioner, 
whose  name  is  known  to  the  country,  is  prescribing 
the  hoof  of  a  horse  for  epilepsy.  It  was  doubtless  sug 
gested  by  that  old  fancy  of  wearing  a  portion  of  elk's- 
hoof  hung  round  the  neck  or  in  a  ring,  for  this  disease. 
But  it  is  hard  to  persuade  reasonable  people  to  swal 
low  the  abominations  of  a  former  period.  The  evi 
dence  which  satisfied  Fernelius  will  not  serve  one  of 
our  hospital  physicians. 

In  this  way  those  articles  of  the  Materia  Medica 
which  had  nothing  but  loathsomeness  to  recommend 
them  have  been  gradually  dropped,  and  are  not  like 
to  obtain  any  general  favor  again  with  civilized  com 
munities.  The  next  culprits  to  be  tried  are  the  poi 
sons.  I  have  never  been  in  the  least  sceptical  as  to 
the  utility  of  some  of  them,  when  properly  employed. 
Though  I  believe  that  at  present,  taking  the  world  at 
large,  and  leaving  out  a  few  powerful  agents  of  such 


BORDER   LINES   IN   MEDICAL   SCIENCE.  263 

immense  value  that  they  rank  next  to  food  in  impor 
tance,  the  poisons  prescribed  for  disease  do  more  hurt 
than  good,  I  have  no  doubt,  and  never  professed  to 
nave  any,  that  they  do  much  good  in  prudent  and  in 
structed  hands.  But  I  am  very  willing  to  confess  a 
great  jealousy  of  many  agents,  and  I  could  almost  wish 
to  see  the  Materia  Meclica  so  classed  as  to  call  sus 
picion  upon  certain  ones  among  them. 

Thus  the  alien  elements,  those  which  do  not  prop 
erly  enter  into  the  composition  of  any  living  tissue,  are 
the  most  to  be  suspected,  —  mercury,  lead,  antimony, 
silver,  and  the  rest,  for  the  reasons  I  have  before  men 
tioned.  Even  iodine,  which,  as  it  is  found  in  certain 
plants,  seems  less  remote  from  the  animal  tissues,  gives 
unequivocal  proofs  from  time  to  time  that  it  is  hostile 
to  some  portions  of  the  glandular  system. 

There  is,  of  course,  less  primd  fade  objection  to 
those  agents  which  consist  of  assimilable  elements, 
such  as  are  found  making  a  part  of  healthy  tissues. 
These  are  divisible  into  three  classes,  —  foods,  poisons, 
and  inert,  mostly  because  insoluble,  substances.  The 
food  of  one  animal  or  of  one  human  being  is  some 
times  poison  to  another,  and  vice  versa,  inert  sub 
stances  may  act  mechanically,  so  as  to  produce  the 
effect  of  poisons ;  but  this  division  holds  exactly 
enough  for  our  purpose. 

Strictly  speaking,  every  poison  consisting  of  assimi 
lable  elements  may  be  considered  as  unwholesome 
food.  It  is  rejected  by  the  stomach,  or  it  produces 
diarrhoea,  or  it  causes  vertigo  or  disturbance  of  the 
heart's  action,  or  some  other  symptom  for  which  the 
subject  of  it  would  consult  the  physician,  if  it  came  on 
from  any  other  cause  than  taking  it  under  the  name 
of  medicine.  Yet  portions  of  this  unwholesome  food 


264  MEDICAL  ESSAYS. 

which  we  call  medicine,  we  have  reason  to  believe,  ar6 
assimilated ;  thus,  castor-oil  appears  to  be  partially  di 
gested  by  infants,  so  that  they  require  large  doses  to 
affect  them  medicinally.  Even  that  deadliest  of  poi 
sons,  hydrocyanic  acid,  is  probably  assimilated,  and 
helps  to  make  living  tissue,  if  it  do  not  kill  the  pa 
tient,  for  the  assimilable  elements  which  it  contains, 
given  in  the  separate  forms  of  amygdalin  and  emul- 
sin,  produce  no  disturbance,  unless,  as  in  Bernard's 
experiments,  they  are  suffered  to  meet  in  the  digestive 
organs.  A  medicine  consisting  of  assimilable  sub 
stances  being  then  simply  unwholesome  food,  we  un 
derstand  what  is  meant  by  those  cumulative  effects  of 
such  remedies  often  observed,  as  in  the  case  of  digi 
talis  and  strychnia.  They  are  precisely  similar  to  the 
cumulative  effects  of  a  salt  diet  in  producing  scurvy, 
or  of  spurred  rye  in  producing  dry  gangrene.  As  the 
effects  of  such  substances  are  a  violence  to  the  organs, 
we  should  exercise  the  same  caution  with  regard  to 
their  use  that  we  would  exercise  about  any  other  kind 
of  poisonous  food,  —  partridges  at  certain  seasons,  for 
instance.  Even  where  these  poisonous  kinds  of  food 
seem  to  be  useful,  we  should  still  regard  them  with 
great  jealousy.  Digitalis  lowers  the  pulse  in  febrile 
conditions.  Veratrum  viride  does  the  same  thing. 
How  do  we  know  that  a  rapid  pulse  is  not  a  normal 
adjustment  of  nature  to  the  condition  it  accompanies  ? 
Digitalis  has  gone  out  of  favor  ;  how  sure  are  we  that 
Veratrum  viride  will  not  be  found  to  do  more  harm 
than  good  in  a  case  of  internal  inflammation,  taking 
the  whole  course  of  the  disease  into  consideration? 
Think  of  the  change  of  opinion  with  regard  to  the  use 
of  opium  in  delirium  tremens  (which  you  remember  ia 
sometimes  called  delirium  vigilans)^  where  it  seemed 


BORDER  LINES  IN  MEDICAL  SCIENCE.  265 

so  obviously  indicated,  since  the  publication  of  Dr. 
Ware's  admirable  essay.  I  respect  the  evidence  of  my 
contemporaries,  but  I  cannot  forget  the  sayings  of  the 
Father  of  medicine,  —  Ars  longa,  judicium  difficile. 

I  am  not  presuming  to  express  an  opinion  concern 
ing  Veratrum  viride,  which  was  little  heard  of  when 
I  was  still  practising  medicine.  I  am  only  appealing 
to  that  higher  court  of  experience  which  sits  in  judg 
ment  on  all  decisions  of  the  lower  medical  tribunals, 
and  which  requires  more  than  one  generation  for  its 
final  verdict. 

Once  change  the  habit  of  mind  so  long  prevalent 
among  practitioners  of  medicine ;  once  let  it  be  every 
where  understood  that  the  presumption  is  in  favor  of 
food,  and  not  of  alien  substances,  of  innocuous,  and 
not  of  unwholesome  food,  for  the  sick ;  that  this  pre 
sumption  requires  very  strong  evidence  in  each  partic 
ular  case  to  overcome  it ;  but  that,  when  such  evidence 
is  afforded,  the  alien  substance  or  the  unwholesome 
food  should  be  given  boldly,  in  sufficient  quantities,  in 
the  same  spirit  as  that  with  which  the  surgeon  lifts  his 
knife  against  a  patient,  —  that  is,  with  the  same  reluc 
tance  and  the  same  determination,  —  and  I  think  we 
shall  have  and  hear  much  less  of  charlatanism  in  and 
out  of  the  profession.  The  disgrace  of  medicine  has 
been  that  colossal  system  of  self-deception,  in  obedi 
ence  to  which  mines  have  been  emptied  of  their  can 
kering  minerals,  the  vegetable  kingdom  robbed  of  all 
its  noxious  growths,  the  entrails  of  animals  taxed  for 
their  impurities,  the  poison-bags  of  reptiles  drained  of 
their  venom,  and  all  the  inconceivable  abominations 
thus  obtained  thrust  down  the  throats  of  human  beings 
suffering  from  some  fault  of  organization,  nourishment, 
or  vital  stimulation. 


266  MEDICAL  ESSAYS. 

Much  as  we  have  gained,  we  have  not  yet  thor 
oughly  shaken  off  the  notion  that  poison  is  the  natural 
food  of  disease,  as  wholesome  aliment  is  the  support  of 
health.  Cowper's  lines,  in  "  The  Task,"  show  the  mat 
ter-of-course  practice  of  his  time :  — 

"  He  does  not  scorn  it,  who  has  long  endured 
A  fever's  agonies,  &ndfed  on  drugs." 

Dr.  Kimball  of  Lowell,  who  has  been  in  the  habit  of 
seeing  a  great  deal  more  of  typhoid  fever  than  most 
practitioners,  and  whose  surgical  exploits  show  him 
not  to  be  wanting  in  boldness  or  enterprise,  can  tell 
you  whether  he  finds  it  necessary  to  feed  his  patients 
on  drugs  or  not.  His  experience  is,  I  believe,  that  of 
the  most  enlightened  and  advanced  portion  of  the  pro 
fession  ;  yet  I  think  that  even  in  typhoid  fever,  and 
certainly  in  many  other  complaints,  the  effects  of  an 
cient  habits  and  prejudices  may  still  be  seen  in  the 
practice  of  some  educated  physicians. 

To  you,  young  men,  it  belongs  to  judge  all  that  has 
gone  before  you.  You  come  nearer  to  the  great  fa 
thers  of  modern  medicine  than  some  of  you  imagine. 
Three  of  my  own  instructors  attended  Dr.  Rush's  Lec 
tures.  The  illustrious  Haller  mentions  Rush's  inau 
gural  thesis  a  in  his  "  Bibliotheca  Anatomica  ;  "  and 
this  same  Haller,  brought  so  close  to  us,  tells  us  he  re 
members  Ruysch,  then  an  old  man,  and  used  to  carry 
letters  between  him  and  Boerhaave.6  Look  through 
the  history  of  medicine  from  Boerhaave  to  this  present 
day.  You  will  see  at  once  that  medical  doctrine  and 
practice  have  undergone  a  long  series  of  changes.  You 

«  De  Coctione  Ciborvm  in  Ventriculo.  Edinb.  1 768.  —  Bibl 
Anat.  ii.  657. 

*  "  Saepissime  bonum  senem  vidi,  ssepe  BOBRHAAVIUM  inter 
et  ipsum  literarum  vector."  —  Ibid.  i.  529. 


BOEDER   LINES   IN   MEDICAL   SCIENCE.  267 

will  see  that  the  doctrine  and  practice  of  our  own  time 
must  probably  change  in  their  turn,  and  that,  if  we 
can  trust  at  all  to  the  indications  of  their  course,  it 
will  be  in  the  direction  of  an  improved  hygiene  and  a 
simplified  treatment.  Especially  will  the  old  habit  of 
violating  the  instincts  of  the  sick  give  place  to  a  judi 
cious  study  of  these  same  instincts.  It  will  be  found 
that  bodily,  like  mental  insanity,  is  best  managed,  for 
the  most  part,  by  natural  soothing  agencies.  Two  cen 
turies  ago  there  was  a  prescription  for  scurvy  contain 
ing  "  stercoris  taurini  et  anserini  par  quantitas  trium 
magnarum  nucum"  of  the  hell-broth  containing  which 
"  quoties-cumque  sitit  ceger,  large  bibit"  a  When  I 
have  recalled  the  humane  common-sense  of  Captain 
Cook  in  the  matter  of  preventing  this  disease ;  when  I 
have  heard  my  friend,  Mr.  Dana,  describing  the  avid 
ity  with  which  the  scurvy-stricken  sailors  snuffed  up 
the  earthy  fragrance  of  fresh  raw  potatoes,  the  food 
which  was  to  supply  the  elements  wanting  to  their 
spongy  tissues,  I  have  recognized  that  the  perfection 
of  art  is  often  a  return  to  nature,  and  seen  in  this  sin 
gle  instance  the  germ  of  innumerable  beneficent  future 
medical  reforms. 

I  cannot  help  believing  that  medical  curative  treat 
ment  will  by  and  by  resolve  itself  in  great  measure 
into  modifications  of  the  food,  swallowed  and  breathed, 
and  of  the  natural  stimuli,  and  that  less  will  be  ex 
pected  from  specifics  and  noxious  disturbing  agents, 
either  alien  or  assimilable.  The  noted  mineral-waters 
containing  iron,  sulphur,  carbonic  acid,  supply  nutri 
tious  or  stimulating  materials  to  the  body  as  much  as 
phosphate  of  lime  and  ammoniacal  compounds  do  to 
the  cereal  plants.  The  effects  of  a  milk  and  vegetable 

•  Schenck,  Observ.  Med.  Ear,  (Lugduni,  1643).  p.  800. 


268  MEDICAL  ESSAYS. 

diet,  of  gluten  bread  in  diabetes,  of  cod-liver  oil  in 
phthisis,  even  of  such  audacious  innovations  as  the 
water-cure  and  the  grape-cure,  are  only  hints  of  what 
will  be  accomplished  when  we  have  learned  to  discover 
what  organic  elements  are  deficient  or  in  excess  in  a 
case  of  chronic  disease,  and  the  best  way  of  correcting 
the  abnormal  condition,  just  as  an  agriculturist  ascer 
tains  the  wants  of  his  crops  and  modifies  the  composi 
tion  of  his  soil.  In  acute  febrile  diseases  we  have  long 
ago  discovered  that  far  above  all  drug-medication  is 
the  use  of  mild  liquid  diet  in  the  period  of  excitement, 
and  of  stimulant  and  nutritious  food  in  that  of  ex- 
haustion.  Hippocrates  himself  was  as  particular  about 
his  barley-ptisan  as  any  Florence  Nightingale  of  our 
time  could  be. 

The  generation  to  which  you,  who  are  just  entering 
the  profession,  belong,  will  make  a  vast  stride  forward, 
as  I  believe,  in  the  direction  of  treatment  by  natural 
rather  than  violent  agencies.  What  is  it  that  makes 
the  reputation  of  Sydenham,  as  the  chief  of  English 
physicians  ?  His  prescriptions  consisted  principally  of 
simples.  An  aperient  or  an  opiate,  a  "  cardiac  "  or  a 
tonic,  may  be  commonly  found  in  the  midst  of  a  some 
what  fantastic  miscellany  of  garden  herbs.  It  was  not 
by  his  pharmaceutic  prescriptions  that  he  gained  his 
great  name.  It  was  by  daring  to  order  fresh  air  for 
small-pox  patients,  and  riding  on  horseback  for  con 
sumptives,  in  place  of  the  smothering  system,  and  the 
noxious  and  often  loathsome  rubbish  of  the  established 
schools.  Of  course  Sydenham  was  much  abused  by 
his  contemporaries,  as  he  frequently  takes  occasion  to 
remind  his  reader.  "  I  must  needs  conclude,"  he  says, 
*'  either  that  I  am  void  of  merit,  or  that  the  candid 
and  ingenuous  part  of  mankind,  who  are  formed  with 


BORDER  LINES   IN  MEDICAL   SCIENCE.  269 

so  excellent  a  temper  of  mind  as  to  be  no  strangers  to 
gratitude,  make  a  very  small  part  of  the  whole."  a  If 
in  the  fearless  pursuit  of  truth  you  should  find  the 
world  as  ungracious  in  the  nineteenth  century  as  he 
found  it  in  the  seventeenth,  you  may  learn  a  lesson  of 
self-reliance  from  another  utterance  of  the  same  illus 
trious  physician :  "  'T  is  none  of  my  business  to  inquire 
what  other  persons  think,  but  to  establish  my  own  ob 
servations  ;  in  order  to  which,  I  ask  no  favor  of  the 
reader  but  to  peruse  my  writings  with  temper."  * 

The  physician  has  learned  a  great  deal  from  the 
surgeon,  who  is  naturally  in  advance  of  him,  because 
he  has  a  better  opportunity  of  seeing  the  effects  of  his 
remedies.  Let  me  shorten  one  of  Ambroise  Park's 
stories  for  you.  There  had  been  a  great  victory  at  the 
pass  of  Susa,  and  they  were  riding  into  the  city.  The 
wounded  cried  out  as  the  horses  trampled  them  under 
their  hoofs,  which  caused  good  Ambroise  great  pity, 
and  made  him  wish  himself  back  in  Paris.  Going  into 
a  stable  he  saw  four  dead  soldiers,  and  three  desper 
ately  wounded,  placed  with  their  backs  against  the 
wall.  An  old  campaigner  came  up.  —  "  Can  these  fel 
lows  get  well  ?  "  he  said.  "  No  !  "  answered  the  sur 
geon.  Thereupon,  the  old  soldier  walked  up  to  them 
and  cut  all  their  throats,  sweetly,  and  without  wrath 
(doulcement  et  sans  cholere).  Ambroise  told  him  he 
was  a  bad  man  to  do  such  a  thing.  "  I  hope  to  God," 
he  said,  "  somebody  will  do  as  much  for  me  if  I  ever 
get  into  such  a  scrape "  (accoustr£  de  telle  fa$on). 
"  I  was  not  much  salted  in  those  days  "  (jbien  doux  de 
seZ),  says  Ambroise,  "  and  little  acquainted  with  the 

"  Of  the  Small-Pox  and  Hysteric  Diseases.  Epistle  to  Dr.  WU- 
Sam  Cole,  §  140,  Swan's  Translation. 
*  Works,  Preface,  p.  xxL 


270  MEDICAL  ESSAYS. 

treatment  of  wounds."  However,  as  lie  tells  us,  he 
proceeded  to  apply  boiling  oil  of  Sambuc  (elder)  after 
the  approved  fashion  of  the  time,  —  with  what  torture 
to  the  patient  may  be  guessed.  At  last  his  precious 
oil  gave  out,  and  he  used  instead  an  insignificant  mix 
ture  of  his  own  contrivance.  He  could  not  sleep  that 
night  for  fear  his  patients  who  had  riot  been  scalded 
with  the  boiling  oil  would  be  poisoned  by  the  gunpow 
der  conveyed  into  their  wounds  by  the  balls.  To  his 
surprise,  he  found  them  much  better  than  the  others 
the  next  morning,  and  resolved  never  again  to  burn 
his  patients  with  hot  oil  for  gun-shot  wounds.8 

This  was  the  beginning,  as  nearly  as  we  can  fix  it, 
of  that  reform  which  has  introduced  plain  water-dress 
ings  in  the  place  of  the  farrago  of  external  applications 
which  had  been  a  source  of  profit  to  apothecaries  and 
disgrace  to  art  from,  and  before,  the  time  when  Pliny 
complained  of  them.  A  young  surgeon  who  was  at 
Sudley  Church,  laboring  among  the  wounded  of  Bull 
Run,  tells  me  they  had  nothing  but  water  for  dressing, 
and  he  (being  also  doux  de  seT)  was  astonished  to  see 
how  well  the  wounds  did  under  that  simple  treatment. 

Let  me  here  mention  a  fact  or  two  which  may  be  of 
use  to  some  of  you  who  mean  to  enter  the  public  ser 
vice.  You  will,  as  it  seems,  have  gun-shot  wounds  al 
most  exclusively  to  deal  with.  Three  different  sur 
geons,  the  one  just  mentioned  and  two  who  saw  the 
wounded  of  Big  Bethel,  assured  me  that  they  found  no 
sabre-cuts  or  bayonet  wounds.  It  is  the  rifle-bullet 
from  a  safe  distance  which  pierces  the  breasts  of  our 
soldiers,  and  not  the  gallant  charge  of  broad  platoons 
and  sweeping  squadrons,  such  as  we  have  been  in  the 

0  Le  Voyage  de  Thurin,  (Euvres  (Paris,  1579),  p.  1198. 


BOEDER   LINES   IN   MEDICAL    SCIENCE.  271 

habit  of  considering  the  chosen  mode  of  warfare  of 
ancient  and  modern  chivalry." 

Another  fact  parallels  the  story  of  the  old  cam 
paigner,  and  may  teach  some  of  you  caution  in  se 
lecting  your  assistants.  A  chaplain  told  it  to  two  of 
our  officers  personally  known  to  myself.  He  overheard 
the  examination  of  a  man  who  wished  to  drive  one  of 
the  "  avalanche  "  wagons,  as  they  call  them.  The  man 
was  asked  if  he  knew  how  to  deal  with  wounded  men. 
"  Oh  yes,"  he  answered ;  "  if  they  're  hit  here"  point 
ing  to  the  abdomen,  "  knock  'em  on  the  head,  —  they 
can't  get  well." 

In  art  and  outside  of  it  you  will  meet  the  same  bar 
barisms  that  Ambroise  Pare*  met  with, —  for  men  differ 
less  from  century  to  century  than  we  are  apt  to  sup 
pose  ;  you  will  encounter  the  same  opposition,  if  you 
attack  any  prevailing  opinion,  that  Sydenham  com 
plained  of.  So  far  as  possible,  let  not  such  experi 
ences  breed  in  you  a  contempt  for  those  who  are  the 
subjects  of  folly  or  prejudice,  or  foster  any  love  of  dis 
pute  for  its  own  sake.  Should  you  become  authors, 
express  your  opinions  freely ;  defend  them  rarely.  It 
is  not  often  that  an  opinion  is  worth  expressing,  which 

•  Sir  Charles  James  Napier  had  the  same  experience  in  Vir 
ginia  in  1813.  "  Potomac.  We  have  nasty  sort  of  fighting  here, 
amongst  creeks  and  bushes,  and  lose  men  without  show." 
"  Yankee  never  shows  himself,  he  keeps  in  the  thickest  wood, 
fires  and  runs  off."  "These  five  thousand  in  the  open  field 
might  be  attacked,  but  behind  works  it  would  be  throwing  away 
lives."  He  calls  it  "  an  inglorious  warfare," —  says  one  of  the 
eaders  is  "a  little  deficient  in  gumption,"  —  but  "still  my 
opinion  is,  that  if  we  tuck  up  our  sleeves  and  lay  our  ears  back 
we  might  thrash  them  ;  that  is,  if  we  caught  them  out  of  their 
trees,  so  as  to  slap  at  them  with  the  bayonet."  —  Life,  etc.  voL 
I  p.  218  et  seq. 


272  MEDICAL  ESSAYS. 

cannot  take  care  of  itself.  Opposition  is  the  best  mor 
dant  to  fix  the  color  of  your  thought  in  the  general 
belief. 

It  is  time  to  bring  these  crowded  remarks  to  a  close. 
The  day  has  been  when  at  the  beginning  of  a  course  of 
Lectures  I  should  have  thought  it  fitting  to  exhort 
you  to  diligence  and  entire  devotion  to  your  tasks  as 
students.  It  is  not  so  now.  The  young  man  who  has 
not  heard  the  clarion-voices  of  honor  and  of  duty  now 
sounding  throughout  the  land,  will  heed  no  word  of 
mine.  In  the  camp  or  the  city,  in  the  field  or  the 
hospital,  under  sheltering  roof,  or  half-protecting  can 
vas,  or  open  sky,  shedding  our  own  blood  or  stanching 
that  of  our  wounded  defenders,  students  or  teachers, — 
whatever  our  calling  and  our  ability,  we  belong,  not  to 
ourselves,  but  to  our  imperilled  country,  whose  danger 
is  our  calamity,  whose  ruin  would  be  our  enslavement, 
whose  rescue  shall  be  our  earthly  salvation  1 


V. 

SCHOLASTIC  AND  BEDSIDE  TEACHING.* 

THE  idea  is  entertained  by  some  of  our  most  sincere 
professional  brethren,  that  to  lengthen  and  multiply 
our  Winter  Lectures  will  be  of  necessity  to  advance 
the  cause  of  medical  education.  It  is  a  fair  subject 
for  consideration  whether  they  do  not  overrate  the 
relative  importance  of  that  particular  mode  of  instruc 
tion  which  forms  the  larger  part  of  these  courses. 

As  this  School  could  only  lengthen  its  lecture  term 
at  the  expense  of  its  "  Summer  Session,"  in  which 
more  direct,  personal,  and  familiar  teaching  takes  the 
place  of  our  academic  discourses,  and  in  which  more 
time  can  be  given  to  hospitals,  infirmaries,  and  prac 
tical  instruction  in  various  important  specialties,  what 
ever  might  be  gained,  a  good  deal  would  certainly  be 
lost  in  our  case  by  the  exchange. 

The  most  essential  part  of  a  student's  instruction  is 
obtained,  as  I  believe,  not  in  the  lecture-room,  but  at 
the  bedside.  Nothing  seen  there  is  lost ;  the  rhythms 
of  disease  are  learned  by  frequent  repetition ;  its  un 
foreseen  occurrences  stamp  themselves  indelibly  in  the 
memory.  Before  the  student  is  aware  of  what  he  has 
acquired,  he  has  learned  the  aspects  and  course  and 
probable  issue  of  the  diseases  he  has  seen  with  his 
teacher,  and  the  proper  mode  of  dealing  with  them,  so 

•  An  Introductory  Lecture  delivered  before  the  Medical  Class 
of  Harvard  University,  November  6,  1867. 


274  MEDICAL  ESSAYS. 

far  as  his  master  knows  it.  On  the  other  hand,  oui 
ex  cathedra  prelections  have  a  strong  tendency  to  run 
into  details  which,  however  interesting  they  may  be  to 
ourselves  and  a  few  of  our  more  curious  listeners,  have 
nothing  in  them  which  will  ever  be  of  use  to  the  stu 
dent  as  a  practitioner.  It  is  a  perfectly  fair  question 
whether  I  and  some  other  American  Professors  do  not 
teach  quite  enough  that  is  useless  already.  Is  it  not 
well  to  remind  the  student  from  time  to  time  that  a 
physician's  business  is  to  avert  disease,  to  heal  the  sick, 
to  prolong  life,  and  to  diminish  suffering?  Is  it  not 
true  that  the  young  man  of  average  ability  will  find  it 
as  much  as  he  can  do  to  fit  himself  for  these  simple 
duties  ?  Is  it  not  best  to  begin,  at  any  rate,  by  making 
sure  of  such  knowledge  as  he  will  require  in  his  daily 
walk,  by  no  means  discouraging  him  from  any  study 
for  which  his  genius  fits  him  when  he  once  feels  that 
he  has  become  master  of  his  chosen  art. 

I  know  that  many  branches  of  science  are  of  the 
greatest  value  as  feeders  of  our  medical  reservoirs. 
But  the  practising  physician's  office  is  to  draw  the 
healing  waters,  and  while  he  gives  his  time  to  this 
labor  he  can  hardly  be  expected  to  explore  all  the 
sources  that  spread  themselves  over  the  wide  domain 
of  science.  The  traveller  who  would  not  drink  of  the 
Nile  until  he  had  tracked  it  to  its  parent  lakes,  would 
be  like  to  die  of  thirst ;  and  the  medical  practitioner 
who  would  not  use  the  results  of  many  laborers  in 
other  departments  without  sharing  their  special  toils, 
would  find  life  far  too  short  and  art  immeasurably  too 
long. 

We  owe  much  to  Chemistry,  one  of  the  most  capti 
vating  as  well  as  important  of  studies ;  but  the  medical 
man  must  as  a  general  rule  content  himself  with  a 


SCHOLASTIC   AND   BEDSIDE  TEACHING.          275 

clear  view  of  its  principles  and  a  limited  acquaintance 
with  its  facts ;  such  especially  as  are  pertinent  to  his 
pursuits.  I  am  in  little  danger  of  underrating  Anat 
omy  or  Physiology ;  but  as  each  of  these  branches 
splits  up  into  specialties,  any  one  of  which  may  take 
up  a  scientific  life-time,  I  would  have  them  taught  with 
a  certain  judgment  and  reserve,  so  that  they  shall  not 
crowd  the  more  immediately  practical  branches.  So 
of  all  the  other  ancillary  and  auxiliary  kinds  of  knowl 
edge,  I  would  have  them  strictly  subordinated  to  that 
particular  kind  of  knowledge  for  which  the  community 
looks  to  its  medical  advisers. 

A  medical  school  is  not  a  scientific  school,  except 
just  so  far  as  medicine  itself  is  a  science.  On  the  nat 
ural  history  side,  medicine  is  a  science  ;  on  the  cura 
tive  side,  chiefly  an  art.  This  is  implied  in  Hufeland's 
aphorism :  "  The  physician  must  generalize  the  disease 
and  individualize  the  patient." 

The  coordinated  and  classified  results  of  empirical 
observation,  in  distinction  from  scientific  experiment, 
have  furnished  almost  all  we  know  about  food,  the 
medicine  of  health,  and  medicine,  the  food  of  sickness. 
We  eat  the  root  of  the  Solanum  tuberosum  and  throw 
away  its  fruit ;  we  eat  the  fruit  of  the  Solanum  Ly- 
copersicum  and  throw  away  its  root.  Nothing  but  vul 
gar  experience  has  taught  us  to  reject  the  potato  ball 
and  cook  the  tomato.  So  of  most  of  our  remedies. 
The  subchloride  of  mercury,  calomel,  is  the  great  Brit 
ish  specific ;  the  protochloride  of  mercury,  corrosive 
sublimate,  kills  like  arsenic,  but  no  chemist  could  have 
told  us  it  would  be  so. 

From  observations  like  these  we  can  obtain  certain 
principles  from  which  we  can  argue  deductively  to 
facts  of  a  like  nature,  but  the  process  is  limited,  and 


276  MEDICAL  ESSAYS. 

we  are  suspicious  of  all  reasoning  in  that  direction  ap 
plied  to  the  processes  of  healthy  and  diseased  life.  We 
are  continually  appealing  to  special  facts.  We  are 
willing  to  give  Liebig's  artificial  milk  when  we  cannot 
do  better,  but  we  watch  the  child  anxiously  whose  wet- 
nurse  is  a  chemist's  pipkin.  A  pair  of  substantial 
mammary  glands  has  the  advantage  over  the  two  hem 
ispheres  of  the  most  learned  Professor's  brain,  in  the 
art  of  compounding  a  nutritious  fluid  for  infants. 

The  bedside  is  always  the  true  centre  of  medical 
teaching.  Certain  branches  must  be  taught  in  the 
lecture-room,  and  will  necessarily  involve  a  good  deal 
that  is  not  directly  useful  to  the  future  practitioner. 
But  the  over  ambitious  and  active  student  must  not  be 
led  away  by  the  seduction  of  knowledge  for  its  own 
sake  from  his  principal  pursuit.  The  humble  beginner, 
who  is  alarmed  at  the  vast  fields  of  knowledge  opened 
to  him,  may  be  encouraged  by  the  assurance  that  with 
a  very  slender  provision  of  science,  in  distinction  from 
practical  skill,  he  may  be  a  useful  and  acceptable  mem 
ber  of  the  profession  to  which  the  health  of  the  com 
munity  is  intrusted. 

To  those  who  are  not  to  engage  in  practice,  the  vari 
ous  pursuits  of  science  hardly  require  to  be  commended. 
Only  they  must  not  be  disappointed  if  they  find  many 
subjects  treated  in  our  courses  as  a  medical  class  re 
quires,  rather  than  as  a  scientific  class  would  expect, 
that  is,  with  special  limitations  and  constant  reference 
to  practical  ends.  Fortunately  they  are  within  easy 
reach  of  the  highest  scientific  instruction.  The  busi 
ness  of  a  school  like  this  is  to  make  useful  working 
physicians,  and  to  succeed  in  this  it  is  almost  as  im 
portant  not  to  overcrowd  the  mind  of  the  pupil  with 
merely  curious  knowledge  as  it  is  to  store  it  with  use 
ful  information. 


SCHOLASTIC  AND   BEDSIDE  TEACHING.          277 

In  this  direction  I  have  written  my  lecture,  not  to 
undervalue  any  form  of  scientific  labor  in  its  place,  — 
an  unworthy  thought  from  which  I  hope  I  need  not 
defend  myself,  —  but  to  discourage  any  undue  infla 
tion  of  the  scholastic  programme,  which  even  now 
asks  more  of  the  student  than  the  teacher  is  able  to 
obtain  from  the  great  majority  of  those  who  present 
themselves  for  examination.  I  wish  to  take  a  hint  in 
education  from  the  Secretary  of  the  Massachusetts 
Board  of  Agriculture,  who  regards  the  cultivation  of 
too  much  land  as  a  great  defect  in  our  New  England 
farming.  I  hope  that  our  Medical  Institutions  may 
never  lay  themselves  open  to  the  kind  of  accusation 
Mr.  Lowe  brings  against  the  English  Universities, 
when  he  says  that  their  education  is  made  up  •"  of  words 
chat  few  understand  and  most  will  shortly  forget ;  of 
arts  that  can  never  be  used,  if  indeed  they  can  even  be 
learnt ;  of  histories  inapplicable  to  our  times ;  of  lan 
guages  dead  and  even  mouldy ;  of  grammatical  rules 
that  never  had  living  use  and  are  only  post  mortem 
examinations ;  and  of  statements  fagoted  with  utter 
disregard  of  their  comparative  value." 

This  general  thought  will  be  kept  in  view  through 
out  my  somewhat  discursive  address,  which  will  begin 
with  an  imaginary  clinical  lesson  from  the  lips  of  an 
historical  personage,  and  close  with  the  portrait  from 
real  life  of  one  who,  both  as  teacher  and  practitioner, 
was  long  loved  and  honored  among  us.  If  I  somewhat 
overrun  my  hour,  you  must  pardon  me,  for  I  can  say 
with  Pascal  that  I  have  not  had  the  time  to  make  my 
lecture  shorter. 

In  the  year  1647,  that  good  man  John  Eliot,  com 
monly  called  the  Apostle  Eliot,  writing  to  Mr.  Thomaf 


278  MEDICAL  ESSAYS. 

Shepherd,  the  pious  minister  of  Cambridge,  referring 
to  the  great  need  of  medical  instruction  for  the  Indians, 
used  these  words  :  — 

"  I  have  thought  in  my  heart  that  it  were  a  singular 
good  work,  if  the  Lord  would  stirre  up  the  hearts  of 
some  or  other  of  his  people  in  England  to  give  some 
maintenance  toward  some  Schoole  or  Collegiate  exer 
cise  this  way,  wherein  there  should  be  Anatomies  and 
other  instructions  that  way,  and  where  there  might  be 
some  recompence  given  to  any  that  should  bring  in  any 
vegetable  or  other  thing  that  is  vertuous  in  the  way 
of  Physick. 

"  There  is  another  reason  which  moves  my  thought 
and  desires  this  way,  namely  that  our  young  students 
in  Physick  may  be  trained  up  better  then  they  yet  bee, 
who  have  onely  theoretical!  knowledge,  and  are  forced 
to  fall  to  practise  before  ever  they  saw  an  Anatomy 
made,  or  duely  trained  up  in  making  experiments,  for 
we  never  had  but  one  Anatomy  in  the  countrey,  which 
Mr.  Giles  Firman  [Firmin]  now  in  England,  did  make 
and  read  upon  very  well,  but  no  more  of  that  now." 

Since  the  time  of  the  Apostle  Eliot  the  Lord  has 
stirred  up  the  hearts  of  our  people  to  the  building  of 
many  Schools  and  Colleges  where  medicine  is  taught 
in  all  its  branches.  Mr.  Giles  Firmin's  "  Anatomy  " 
may  be  considered  the  first  ancestor  of  a  long  line  of 
skeletons  which  have  been  dangling  and  rattling  in 
our  lecture-rooms  for  more  than  a  century. 

Teaching  in  New  England  in  1647  was  a  grave  but 
simple  matter.  A  single  person,  combining  in  many 
cases,  as  in  that  of  Mr.  Giles  Firmin,  the  offices  of 
physician  and  preacher,  taught  what  he  knew  to  a  few 
disciples  whom  he  gathered  about  him.  Of  the  making 
of  that  "  Anatomy  "  on  which  my  first  predecessor  in 


SCHOLASTIC   AND   BEDSIDE   TEACHING.  279 

the  branch  I  teach  "  did  read  very  well  "  we  can  know 
nothing.  The  body  of  some  poor  wretch  who  had 
swung  upon  the  gallows,  was  probably  conveyed  by 
night  to  some  lonely  dwelling  at  the  outskirts  of  the 
village,  and  there  by  the  light  of  flaring  torches  hastily 
dissected  by  hands  that  trembled  over  the  unwonted 
task.  And  ever  and  anon  the  master  turned  to  his 
book,  as  he  laid  bare  the  mysteries  of  the  hidden  or 
gans  ;  to  his  precious  Vesalius,  it  might  be,  or  his  fig 
ures  repeated  in  the  multifarious  volume  of  Ambroise 
Pare* ;  to  the  Aldine  octavo  in  which  Fallopius  recorded 
his  fresh  observations  ;  or  that  giant  folio  of  Spigelius 
just  issued  from  the  press  of  Amsterdam,  in  which 
lovely  ladies  display  their  viscera  with  a  coquettish 
grace  implying  that  it  is  rather  a  pleasure  than  other 
wise  to  show  the  lace-like  omentum,  and  hold  up  their 
appendices  epiploicse  aa  if  they  were  saying  "  these  are 
our  jewels." 

His  teaching  of  medicine  was  no  doubt  chiefly  clin 
ical,  and  received  with  the  same  kind  of  faith  as  that 
which  accepted  his  words  from  the  pulpit.  His  notions 
of  disease  were  based  on  what  he  had  observed,  seen 
always  in  the  light  of  the  traditional  doctrines  in  which 
he  was  bred.  His  discourse  savored  of  the  weighty 
doctrines  of  Hippocrates,  diluted  by  the  subtle  specu 
lations  of  Galen,  reinforced  by  the  curious  comments 
of  the  Arabian  schoolmen  as  they  were  conveyed  in  the 
mellifluous  language  of  Fernelius,  blended,  it  may  be, 
with  something  of  the  lofty  mysticism  of  Van  Hehnont, 
and  perhaps  stealing  a  flavor  of  that  earlier  form  of 
HonuBopathy  which  had  lately  come  to  light  in  Sir 
Kenelm  Digby's  "Discourse  concerning  the  Cure  of 
Wounds  by  the  Sympathetic  Powder." 

His  Pathology  was  mythology.     A  malformed  foetus. 


280  MEDICAL  ESSAT8. 

as  the  readers  of  Winthrop's  Journal  may  remember, 
was  enough  to  scare  the  colonists  from  their  propriety, 
and  suggest  the  gravest  fears  of  portended  disaster. 
The  student  of  the  seventeenth  century  opened  his 
Licetus  and  saw  figures  of  a  lion  with  the  head  of  a 
woman,  and  a  man  with  the  head  of  an  elephant.  He 
had  offered  to  his  gaze,  as  born  of  a  human  mother,  the 
effigy  of  a  winged  cherub,  a  pterocephalous  specimen, 
which  our  Professor  of  Pathological  Anatomy  would 
hardly  know  whether  to  treat  with  the  reverence  due 
to  its  celestial  aspect,  or  to  imprison  in  one  of  his  im 
mortalizing  jars  of  alcohol. 

His  pharmacopoeia  consisted  mainly  of  simples,  such 
as  the  venerable  "  Herball  "  of  Gerard  describes  and 
figures  in  abounding  affluence.  St.  John's  wort  and 
Clown's  All-heal,  with  Spurge  and  Fennel,  Saffron  and 
Parsley,  Elder  and  Snake-root,  with  opium  in  some 
form,  and  roasted  rhubarb  and  the  Four  Great  Cold 
Seeds,  and  the  two  Resins,  of  which  it  used  to  be  said 
that  whatever  the  Tacamahaca  has  not  cured,  the  Car- 
anna  will,  with  the  more  familiar  Scammony  and  Jalap 
and  Black  Hellebore,  made  up  a  good  part  of  his  prob 
able  list  of  remedies.  He  would  have  ordered  Iron 
now  and  then,  and  possibly  an  occasional  dose  of  An 
timony.  He  would  perhaps  have  had  a  rheumatic 
patient  wrapped  in  the  skin  of  a  wolf  or  a  wild  cat, 
and  in  case  of  a  malignant  fever  with  "  purples "  or 
petechise,  or  of  an  obstinate  king's  evil,  he  might  have 
prescribed  a  certain  black  powder,  which  had  been 
made  by  calcining  toads  in  an  earthen  pot ;  a  choice 
remedy,  taken  internally,  or  applied  to  any  outward 
grief. 

Except  for  the  toad-powder  and  the  peremptory 
drastics,  one  might  have  borne  up  against  this  herb- 


SCHOLASTIC   AND    BEDSIDE  TEACHING.  281 

doctoring  as  well  as  against  some  more  modern  styles 
of  medication.  Barbeyrac  and  his  scholar  Sydenham 
had  not  yet  cleansed  the  Pharmacopeia  of  its  perilous 
stuff,  but  there  is  no  doubt  that  the  more  sensible  phy 
sicians  of  that  day  knew  well  enough  that  a  good  hon 
est  herb-tea  which  amused  the  patient  and  his  nurses 
was  all  that  was  required  to  carry  him  through  all  com 
mon  disorders. 

The  student  soon  learned  the  physiognomy  of  disease 
by  going  about  with  his  master ;  fevers,  pleurisies, 
asthmas,  dropsies,  fluxes,  small-pox,  sore-throats,  mea 
sles,  consumptions.  He  saw  what  was  done  for  them. 
He  put  up  the  medicines,  gathered  the  herbs,  and  so 
learned  something  of  materia  medica  and  botany.  He 
learned  these  few  things  easily  and  well,  for  he  could 
give  his  whole  attention  to  them.  Chirurgery  was  a 
separate  specialty.  Women  in  child-birth  were  cared 
for  by  midwives.  There  was  no  chemistry  deserving 
the  name  to  require  his  study.  He  did  not  learn  a 
great  deal,  perhaps,  but  what  he  did  learn  was  his 
business,  namely,  how  to  take  care  of  sick  people. 

Let  me  give  you  a  picture  of  the  old-fashioned  way 
of  instruction,  by  carrying  you  with  me  in  imagination 
in  the  company  of  worthy  Master  Giles  Firmin  as  he 
makes  his  round  of  visits  among  the  good  folk  of  Ips 
wich,  followed  by  his  one  student,  who  shall  answer  to 
the  scriptural  name  of  Luke.  It  will  not  be  for  enter 
tainment  chiefly,  but  to  illustrate  the  one  mode  of 
teaching  which  can  never  be  superseded,  and  which,  I 
venture  to  say,  is  more  important  than  all  the  rest  put 
together.  The  student  is  a  green  hand,  as  you  will 
perceive. 

In  the  first  dwelling  they  come  to,  a  stout  fellow  is 
bellowing  with  colic. 


282  MEDICAL   ESSAYS. 

"  He  will  die,  Master,  of  a  surety,  methinks,"  says 
the  timid  youth  in  a  whisper. 

"  Nay,  Luke,"  the  Master  answers,  "  't  is  but  a  dry 
belly-ache.  Didst  thou  not  mark  that  he  stayed  his 
roaring  when  I  did  press  hard  over  the  lesser  bowels  ? 
Note  that  he  hath  not  the  pulse  of  them  with  fevers, 
and  by  what  Dorcas  telleth  me  there  hath  been  no  long 
shutting  up  of  the  vice  naturales.  We  will  steep  cer 
tain  comforting  herbs  which  I  will  shew  thee,  and  put 
them  in  a  bag  and  lay  them  on  his  belly.  Likewise  he 
shall  have  my  cordial  julep  with  a  portion  of  this  con 
fection  which  we  do  call  Theriaca  Andromachi,  which 
hath  juice  of  poppy  in  it,  and  is  a  great  stayer  of  an 
guish.  This  fellow  is  at  his  prayers  to-day,  but  I  war 
rant  thee  he  shall  be  swearing  with  the  best  of  them 
to-morrow." 

They  jog  along  the  bridle-path  on  their  horses  until 
they  come  to  another  lowly  dwelling.  They  sit  a  while 
with  a  delicate  looking  girl  in  whom  the  ingenuous 
youth  naturally  takes  a  special  interest.  The  good 
physician  talks  cheerfully  with  her,  asks  her  a  few 
questions.  Then  to  her  mother :  "  Good-wife,  Mar 
garet  hath  somewhat  profited,  as  she  telleth,  by  the 
goat's  milk  she  hath  taken  night  and  morning.  Do 
thou  pluck  a  maniple  —  that  is  an  ht  ndf ul  —  of  the 
plant  called  Maidenhair,  and  make  a  syrup  therewith 
as  1  have  shewed  thee.  Let  her  take  a  cup  full  of  the 
same,  fasting,  before  she  sleepeth,  also  before  she  riseth 
from  her  bed."  And  so  they  leave  the  house. 

"  What  thinkest  thou,  Luke,  of  the  maid  we  have 
been  visiting  ? "  "  She  seemeth  not  much  ailing, 
Master,  according  to  my  poor  judgment.  For  she  did 
say  she  was  better.  And  she  had  a  red  cheek  and  a 
bright  eye,  and  she  spake  of  being  soon  able  to  walk 


SCHOLASTIC    AND   BEDSIDE   TEACHING.  283 

unto  the  meeting,  and  did  seem  greatly  hopeful,  but 
spare  of  flesh,  methought,  and  her  voice  something 
hoarse,  as  of  one  that  hath  a  defluxion,  with  some  small 
coughing  from  a  cold,  as  she  did  say.  Speak  I  not 
truly,  Master,  that  she  will  be  well  speedily  ?  " 

"  Yea,  Luke,  I  do  think  she  shall  be  well,  and  may 
hap  speedily.  But  it  is  not  here  with  us  she  shall  be 
well.  For  that  redness  of  the  cheek  is  but  the  sign  of 
the  fever  which,  after  the  Grecians,  we  do  call  the  hec 
tical  ;  and  that  shining  of  the  eyes  is  but  a  sickly 
glazing,  and  they  which  do  every  day  get  better  and 
likewise  thinner  and  weaker  shall  find  that  way  lead- 
eth  to  the  church-yard  gate.  This  is  the  malady  which 
the  ancients  did  call  tabes,  or  the  wasting  disease,  and 
some  do  name  the  consumption.  A  disease  whereof 
most  that  fall  ailing  do  perish.  This  Margaret  is 
not  long  for  earth  —  but  she  knoweth  it  not,  and  still 
hopeth." 

"Why,  then,  Master,  didst  thou  give  her  of  thy 
medicine,  seeing  that  her  ail  is  unto  death  ?  " 

"  Thou  shalt  learn,  boy,  that  they  which  are  sick 
must  have  somewhat  wherewith  to  busy  their  thoughts. 
There  be  some  who  do  give  these  tabid  or  consumptives 
a  certain  posset  made  with  lime-water  and  anise  and 
liquorice  and  raisins  of  the  sun,  and  there  be  other 
some  who  do  give  the  juice  of  craw-fishes  boiled  in  bar 
ley-water  with  chicken-broth,  but  these  be  toys,  as  I  do 
think,  and  ye  shall  find  as  good  virtue,  nay  better,  in 
this  syrup  of  the  simple  called  Maidenhair." 

Something  after  this  manner  might  Master  Giles 
Firmin  have  delivered  his  clinical  instructions.  Some 
what  in  this  way,  a  century  and  a  half  later,  another 
New  England  physician,  Dr.  Edward  Augustus  Hoi- 
yoke,  taught  a  young  man  who  came  to  study  with  him. 


284  MEDICAL   ESSAYS. 

a  very  diligent  and  intelligent  youth,  James  Jackson  by 
name,  the  same  whose  portrait  in  his  advanced  years 
hangs  upon  this  wall,  long  the  honored  Professor  of 
Theory  and  Practice  in  this  Institution,  of  whom  I 
shall  say  something  in  this  Lecture.  Our  venerated 
Teacher  studied  assiduously  afterwards  in  the  great 
London  Hospitals,  but  I  think  he  used  to  quote  his  "  old 
Master  "  ten  times  where  he  quoted  Mr.  Cline  or  Dr. 
Woodville  once. 

When  I  compare  this  direct  transfer  of  the  prac 
tical  experience  of  a  wise  man  into  the  mind  of  a  stu 
dent,  —  every  fact  one  that  he  can  use  in  the  battle  of 
life  and  death,  —  with  the  far  off,  unserviceable  "  scien 
tific  "  truths  that  I  and  some  others  are  in  the  habit  of 
teaching,  I  cannot  help  asking  myself  whether,  if  we 
concede  that  our  forefathers  taught  too  little,  there  is 
not  a  possibility  that  we  may  sometimes  attempt  to 
teach  too  much.  I  almost  blush  when  I  think  of  my 
self  as  describing  the  eight  several  facets  on  two  slen 
der  processes  of  the  palate  bone,  or  the  seven  little 
twigs  that  branch  off  from  the  minute  tympanic  nerve, 
and  I  wonder  whether  my  excellent  colleague  feels  in 
the  same  way  when  he  pictures  himself  as  giving  the 
constitution  of  neurin,  which  as  he  and  I  know  very 
well  is  that  of  the  hydrate  of  trimethyle-oxethyle-am- 
monium,  or  the  formula  for  the  production  of  alloxan, 
which,  though  none  but  the  Professors  and  older  stu 
dents  can  be  expected  to  remember  it,  is  C^  H4  N4  Oe-f" 
2  HO,  NO8}=C8  H4  N2  O10+2  CO2+N2+NH4  O,  NO5. 

I  can  hear  the  voice  of  some  rough  iconoclast  ad 
dressing  the  Anatomist  and  the  Chemist  in  tones  of 
contemptuous  indignation :  "  What  is  this  stuff  with 
which  you  are  cramming  the  brains  of  young  men  who 
are  to  hold  the  lives  of  the  community  in  their  hands  ? 


SCHOLASTIC  AND  BEDSIDE  TEACHING.          285 

Here  is  a  man  fallen  in  a  fit ;  you  can  tell  me  all  about 
the  eight  surfaces  of  the  two  processes  of  the  palate- 
bone,  but  you  have  not  had  the  sense  to  loosen  that 
man's  neck-cloth,  and  the  old  women  are  all  calling 
you  a  fool  ?  Here  is  a  fellow  that  has  just  swallowed 
poison.  I  want  something  to  turn  his  stomach  inside 
out  at  the  shortest  notice.  Oh,  you  have  forgotten  the 
dose  of  the  sulphate  of  zinc,  but  you  remember  the  for 
mula  for  the  production  of  alloxan  !  " 

"  Look  you,  Master  Doctor, — if  I  go  to  a  carpenter 
to  come  and  stop  a  leak  in  my  roof  that  is  flooding  the 
house,  do  you  suppose  I  care  whether  he  is  a  botanist 
or  not  ?  Cannot  a  man  work  in  wood  without  knowing 
all  about  endogens  and  exogens,  or  must  he  attend 
Professor  Gray's  Lectures  before  he  can  be  trusted  to 
make  a  box-trap  ?  If  my  horse  casts  a  shoe,  do  you 
think  I  will  not  trust  a  blacksmith  to  shoe  him  until  I 
have  made  sure  that  he  is  sound  on  the  distinction  be 
tween  the  sesquioxide  and  the  protosesquioxide  of 
iron?" 

—  But  my  scientific  labor  is  to  lead  to  useful  results 
by  and  by,  in  the  next  generation,  or  in  some  possible 
remote  future.  — 

"  Diavolo ! "  as  your  Dr.  Rabelais  has  it,  —  answers 
the  iconoclast,  —  "  what  is  that  to  me  and  my  colic,  to 
me  and  my  strangury?  I  pay  the  Captain  of  the 
Cunard  steamship  to  carry  me  quickly  and  safely  to 
Liverpool,  not  to  make  a  chart  of  the  Atlantic  for  after 
voyagers  !  If  Professor  Peirce  undertakes  to  pilot  me 
into  Boston  Harbor  and  runs  me  on  Cohasset  rocks, 
what  answer  is  it  to  tell  me  that  he  is  Superintendent 
of  the  Coast  Survey  ?  No,  Sir  I  I  want  a  plain  man 
in  a  pea-jacket  and  a  sou'wester,  who  knows  the  chan 
nel  of  Boston  Harbor,  and  the  rocks  of  Boston  Harbor, 


286  MEDICAL  ESSAYS. 

and  the  distinguished  Professor  is  quite  of  my  mind  aa 
to  the  matter,  for  I  took  the  pains  to  ask  him  before  I 
ventured  to  use  his  name  in  the  way  of  illustration." 

I  do  not  know  how  the  remarks  of  the  image- 
breaker  may  strike  others,  but  I  feel  that  they  put  me 
on  my  defence  with  regard  to  much  of  my  teaching. 
Some  years  ago  I  ventured  to  show  in  an  introductory 
Lecture  how  very  small  a  proportion  of  the  anatomical 
facts  taught  in  a  regular  course,  as  delivered  by  myself 
and  others,  had  any  practical  bearing  whatever  on  the 
treatment  of  disease.  How  can  I,  how  can  any  medi 
cal  teacher  justify  himself  in  teaching  anything  that  is 
not  like  to  be  of  practical  use  to  a  class  of  young  men 
who  are  to  hold  in  their  hands  the  balance  in  which 
life  and  death,  ease  and  anguish,  happiness  and  wretch 
edness  are  to  be  daily  weighed  ? 

I  hope  we  are  not  all  wrong.  Oftentimes  in  finding 
how  sadly  ignorant  of  really  essential  and  vital  facts 
and  rules  were  some  of  those  whom  we  had  been  lard 
ing  with  the  choicest  scraps  of  science,  I  have  doubted 
whether  the  old  one-man  system  of  teaching,  when  the 
one  man  was  of  the  right  sort,  did  not  turn  out  better 
working  physicians  than  our  more  elaborate  method. 
The  best  practitioner  I  ever  knew  was  mainly  shaped 
to  excellence  in  that  way.  I  can  understand  perfectly 
the  regrets  of  my  friend  Dr.  John  Brown  of  Edin 
burgh,  for  the  good  that  was  lost  with  the  old  appren 
ticeship  system.  I  understand  as  well  Dr.  Latham's 
fear  "  that  many  men  of  the  best  abilities  and  good 
education  will  be  deterred  from  prosecuting  physic  as 
a  profession,  in  consequence  of  the  necessity  indis< 
criminately  laid  upon  all  for  impossible  attainments." 

I  feel  therefore  impelled  to  say  a  very  few  words  in 
defence  of  that  system  of  teaching  adopted  in  our  Col 


SCHOLASTIC   AND   BEDSIDE  TEACHING.          287 

leges,  by  which  we  wish  to  supplement  and  complete 
the  instruction  given  by  private  individuals  or  by  what 
are  often  called  Summer  Schools. 

The  reason  why  we  teach  so  much  that  is  not  prac 
tical  and  in  itself  useful,  is  because  we  find  that  the 
easiest  way  of  teaching  what  is  practical  and  useful. 
If  we  could  in  any  way  eliminate  all  that  would  help 
a  man  to  deal  successfully  with  disease,  and  teach  it 
by  itself  so  that  it  should  be  as  tenaciously  rooted  in 
the  memory,  as  easily  summoned  when  wanted,  as  fer 
tile  in  suggestion  of  related  facts,  as  satisfactory  to  the 
peremptory  demands  of  the  intelligence  as  if  taught  in 
its  scientific  connections,  I  think  it  would  be  our  duty 
so  to  teach  the  momentous  truths  of  medicine,  and  to 
regard  all  useless  additions  as  an  intrusion  on  the  time 
which  should  be  otherwise  occupied. 

But  we  cannot  successfully  eliminate  and  teach  by 
itself  that  which  is  purely  practical.  The  easiest  and 
surest  way  of  acquiring  facts  is  to  learn  them  in 
groups,  in  systems,  and  systematized  knowledge  is  sci 
ence.  You  can  very  often  carry  two  facts  fastened  to 
gether  more  easily  than  one  by  itself,  as  a  housemaid 
can  carry  two  pails  of  water  with  a  hoop  more  easily 
than  one  without  it.  You  can  remember  a  man's  face, 
made  up  of  many  features,  better  than  you  can  his 
nose  or  his  mouth  or  his  eye-brow.  Scores  of  proverbs 
show  you  that  you  can  remember  two  lines  that  rhyme 
better  than  one  without  the  jingle.  The  ancients,  who 
knew  the  laws  of  memory,  grouped  the  seven  cities 
that  contended  for  the  honor  of  being  Homer's  birth 
place  in  a  line  thus  given  by  Aulus  Gellius  :  — 

Smurna,  Rodos,  Colophon,  Salamin,  los,  Argos,  AthenaL 

I  remember,  in  the  earlier  political  days  of  Martin 
Van  Buren,  that  Colonel  Stone,  of  the  "New  York 


288  MEDICAL    ESSAYS. 

Commercial,"  or  one  of  his  correspondents,  said  that 
six  towns  of  New  York  would  claim  in  the  same  way 
to  have  been  the  birth-place  of  the  "  Little  Magician," 
as  he  was  then  called  ;  and  thus  he  gave  their  names, 
any  one  of  which  I  should  long  ago  have  forgotten, 
but  which  as  a  group  have  stuck  tight  in  my  memory 
from  that  day  to  this ;  — 

Catskill,  Saugerties,  Redhook,  Kinderhook,  Scaghticoke,  Scho 
dac. 

If  the  memory  gains  so  much  by  mere  rhythmical 
association,  how  much  more  will  it  gain  when  isolated 
facts  are  brought  together  under  laws  and  principles, 
when  organs  are  examined  in  their  natural  connec 
tions,  when  structure  is  coupled  with  function,  and 
healthy  and  diseased  action  are  studied  as  they  pass 
one  into  the  other !  Systematic,  or  scientific  study  is 
invaluable  as  supplying  a  natural  kind  of  mnemonics, 
if  for  nothing  else.  You  cannot  properly  learn  the 
facts  you  want  from  Anatomy  and  Chemistry  in  any 
way  so  easily  as  by  taking  them  in  their  regular  order, 
with  other  allied  facts,  only  there  must  be  common 
sense  exercised  in  leaving  out  a  great  deal  which  be 
longs  to  each  of  the  two  branches  as  pure  science.  The 
dullest  of  teachers  is  the  one  who  does  not  know  what 
to  omit. 

The  larger  aim  of  scientific  training  is  to  furnish 
you  with  principles  to  which  you  will  be  able  to  refer 
isolated  facts,  and  so  bring  these  within  the  range  of 
recorded  experience.  See  what  the  "  London  Times  " 
said  about  the  three  Germans  who  cracked  open  John 
Bull  Chatwood's  strong-box  at  the  Fair  the  other  day, 
while  the  three  Englishmen  hammered  away  in  vain  at 
Brother  Jonathan  Herring's.  The  Englishmen  repre 
sented  brute  force.  The  Germans  had  been  trained  to 


SCHOLASTIC   AND   BEDSIDE   TEACHING.          289 

appreciate  principle.  The  Englishman  "knows  his 
business  by  rote  and  rule  of  thumb  "  —  science,  which 
would  "  teach  him  to  do  in  an  hour  what  has  hitherto 
occupied  him  two  hours,"  "is  in  a  manner  forbidden 
to  him."  To  this  cause  the  "Times"  attributes  the 
falling  off  of  English  workmen  in  comparison  with 
those  of  the  Continent. 

Granting  all  this,  we  must  not  expect  too  much 
from  "  science "  as  distinguished  from  common  expe 
rience.  There  are  ten  thousand  experimenters  with 
out  special  apparatus  for  every  one  in  the  laboratory. 
Accident  is  the  great  chemist  and  toxicologist.  Battle 
is  the  great  vivisector.  Hunger  has  instituted  re 
searches  on  food  such  as  no  Liebig,  no  Academic  Com 
mission  has  ever  recorded. 

Medicine,  sometimes  impertinently,  often  ignorantly, 
often  carelessly  called  "  allopathy,"  appropriates  every, 
thing  from  every  source  that  can  be  of  the  slightest 
use  to  anybody  who  is  ailing  in  any  way,  or  like  to  be 
ailing  from  any  cause.  It  learned  from  a  monk  how 
to  use  antimony,  from  a  Jesuit  how  to  cure  agues, 
from  a  friar  how  to  cut  for  stone,  from  a  soldier  how 
to  treat  gout,  from  a  sailor  how  to  keep  off  scurvy, 
from  a  postmaster  how  to  sound  the  Eustachian  tube, 
from  a  dairy-maid  how  to  prevent  small-pox,  and  from 
an  old  market-woman  how  to  catch  the  itch-insect.  It 
borrowed  acupuncture  and  the  moxa  from  the  Japan 
ese  heathen,  and  was  taught  the  use  of  lobelia  by  the 
American  savage.  It  stands  ready  to-day  to  accept 
anything  from  any  theorist,  from  any  empiric  who  can 
make  out  a  good  case  for  his  discovery  or  his  remedy. 
M  Science  "  is  one  of  its  benefactors,  but  only  one,  out 
of  many.  Ask  the  wisest  practising  physician  you 
know,  what  branches  of  science  help  him  habitually, 


290  MEDICAL  ESSAYS. 

and  what  amount  of  knowledge  relating  to  each  branch 
he  requires  for  his  professional  duties.  He  will  tell 
you  that  scientific  training  has  a  value  independent  of 
all  the  special  knowledge  acquired.  He  will  tell  you 
that  many  facts  are  explained  by  studying  them  in 
the  wider  range  of  related  facts  to  which  they  belong. 
He  will  gratefully  recognize  that  the  anatomist  has 
furnished  him  with  indispensable  data,  that  the  physi 
ologist  has  sometimes  put  him  on  the  track  of  new 
modes  of  treatment,  that  the  chemist  has  isolated  the 
active  principles  of  his  medicines,  has  taught  him  how 
to  combine  them,  has  from  time  to  time  offered  him 
new  remedial  agencies,  and  so  of  others  of  his  allies. 
But  he  will  also  tell  you,  if  I  am  not  mistaken,  that 
his  own  branch  of  knowledge  is  so  extensive  and  so 
perplexing  that  he  must  accept  most  of  his  facts  ready 
made  at  their  hands.  He  will  own  to  you  that  in  the 
struggle  for  life  which  goes  on  day  and  night  in  our 
thoughts  as  in  the  outside  world  of  nature,  much  that 
he  learned  under  the  name  of  science  has  died  out, 
and  that  simple  homely  experience  has  largely  taken 
the  place  of  that  scholastic  knowledge  to  which  he  and 
perhaps  some  of  his  instructors  once  attached  a  para 
mount  importance. 

This,  then,  is  my  view  of  scientific  training  as  con 
ducted  in  courses  such  as  you  are  entering  on.  Up  to 
a  certain  point  I  believe  in  set  Lectures  as  excellent 
adjuncts  to  what  is  far  more  important,  practical  in 
struction  at  the  bedside,  in  the  operating  room,  and 
under  the  eye  of  the  Demonstrator.  But  I  am  so  far 
from  wishing  these  courses  extended,  that  I  think  some 
of  them  —  suppose  I  say  my  own  —  would  almost  bear 
curtailing.  Do  you  want  me  to  describe  more  branches 
of  the  sciatic  and  crural  nerves  ?  I  can  take  Fischer'a 


SCHOLASTIC   AND   BEDSIDE  TEACHING.          291 

plates,  and  lecturing  on  that  scale  fill  up  my  whole 
course  and  not  finish  the  nerves  alone.  We  must  stop 
somewhere,  and  for  my  own  part  I  think  the  scholastic 
exercises  of  our  colleges  have  already  claimed  their 
full  share  of  the  student's  time  without  our  seeking  to 
extend  them. 

I  trust  I  have  vindicated  the  apparent  inconsequence 
of  teaching  young  students  a  good  deal  that  seems  at 
first  sight  profitless,  but  which  helps  them  to  learn 
and  retain  what  is  profitable.  But  this  is  an  inquisi 
tive  age,  and  if  we  insist  on  piling  up  beyond  a  certain 
height  knowledge  which  is  in  itself  mere  trash  and 
lumber  to  a  man  whose  life  is  to  be  one  long  fight  with 
death  and  disease,  there  will  be  some  sharp  questions 
asked  by  and  by,  and  our  quick-witted  people  will  per 
haps  find  they  can  get  along  as  well  without  the  pro 
fessor's  cap  as  without  the  bishop's  mitre  and  the  mon 
arch's  crown. 

I  myself  have  nothing  to  do  with  clinical  teaching. 
Yet  I  do  not  hesitate  to  say  it  is  more  essential  than 
all  the  rest  put  together,  so  far  as  the  ordinary  prac 
tice  of  medicine  is  concerned ;  and  this  is  by  far  the 
most  important  thing  to  be  learned,  because  it  deals 
with  so  many  more  lives  than  any  other  branch  of  the 
profession.  So  of  personal  instruction,  such  as  we 
give  and  others  give  in  the  interval  of  lectures,  much 
of  it  at  the  bedside,  some  of  it  in  the  laboratory,  some 
in  the  microscope-room,  some  in  the  recitation-room,  I 
think  it  has  many  advantages  of  its  own  over  the  win 
ter  course,  and  I  do  not  wish  to  see  it  shortened  for 
the  sake  of  prolonging  what  seems  to  me  long  enough 
already. 

If  I  am  jealous  of  the  tendency  to  expand  the  time 
given  to  the  acquisition  of  curious  knowledge,  at  the 


292  MEDICAL  ESSAYS. 

expense  of  the  plain  old-fashioned  bedside  teachings,  \ 
only  share  the  feeling  which  Sydenham  expressed  two 
hundred  years  ago,  using  an  image  I  have  already  bor 
rowed.  "  He  would  be  no  honest  and  successful  pilot 
who  was  to  apply  himself  with  less  industry  to  avoid 
rocks  and  sands  and  bring  his  vessel  safely  home,  than 
to  search  into  the  causes  of  the  ebbing  and  flowing  of 
the  sea,  which,  though  very  well  for  a  philosopher,  is 
foreign  to  him  whose  business  it  is  to  secure  the  ship, 
So  neither  will  a  physician,  whose  province  it  is  to  cure 
diseases,  be  able  to  do  so,  though  he  be  a  person  of 
great  genius,  who  bestows  less  time  on  the  hidden  and 
intricate  method  of  nature,  and  adapting  his  means 
thereto,  than  on  curious  and  subtle  speculation.** 

"  Medicine  is  my  wife  and  Science  is  my  mistress," 
said  Dr.  Bush.  I  do  not  think  that  the  breach  of  the 
seventh  commandment  can  be  shown  to  have  been  ol 
advantage  to  the  legitimate  owner  of  his  affections. 
Bead  what  Dr.  Elisha  Bartlett  says  of  him  as  a  prac 
titioner,  or  ask  one  of  our  own  honored  ex-professors, 
who  studied  under  him,  whether  Dr.  Rush  had  ever 
learned  the  meaning  of  that  saying  of  Lord  Bacon, 
that  man  is  the  minister  and  interpreter  of  Nature,  or 
whether  he  did  not  speak  habitually  of  Nature  as  an 
intruder  in  the  sick  room,  from  which  his  art  was  to 
expel  her  as  an  incompetent  and  a  meddler. 

All  a  man's  powers  are  not  too  much  for  such  a  pro 
fession  as  Medicine.  "  He  is  a  learned  man,"  said  old 
Parson  Emmons  of  Franklin,  "  who  understands  one 
subject,  and  he  is  a  very  learned  man  who  understands 
two  subjects."  Schonbein  says  he  has  been  studying 
oxygen  for  thirty  years.  Mitscherlich  said  it  took 
fourteen  years  to  establish  a  new  fact  in  chemistry. 
Aubrey  says  of  Harvey,  the  discoverer  of  the  circuit 


SCHOLASTIC   AND   BEDSIDE   TEACHING.  293 

tion,  that  "  though  all  his  profession  would  allow  him 
to  be  an  excellent  anatomist,  I  have  never  heard  of 
any  who  admired  his  therapeutic  way."  My  learned 
and  excellent  friend  before  referred  to,  Dr.  Brown  of 
Edinburgh,  from  whose  very  lively  and  sensible  Essay, 
"  Locke  and  Sydenham,"  I  have  borrowed  several  of 
my  citations,  contrasts  Sir  Charles  Bell,  the  discov 
erer,  the  man  of  science,  with  Dr.  Abercrombie,  the 
master  in  the  diagnosis  and  treatment  of  disease.  It 
is  through  one  of  the  rarest  of  combinations  that  we 
have  in  our  Faculty  a  teacher  on  whom  the  scientific 
mantle  of  Bell  has  fallen,  and  who  yet  stands  preemi 
nent  in  the  practical  treatment  of  the  class  of  diseases 
which  his  inventive  and  ardent  experimental  genius 
has  illustrated.  M.  Brown-Se'quard's  example  is  as 
eloquent  as  his  teaching  in  proof  of  the  advantages  of 
well  directed  scientific  investigation.  But  those  who 
emulate  his  success  at  once  as  a  discoverer  and  a  prac 
titioner  must  be  content  like  him  to  limit  their  field 
of  practice.  The  highest  genius  cannot  afford  in  our 
time  to  forget  the  ancient  precept,  Divide  et  impera. 

"  I  suppose  I  must  go  and  earn  this guinea," 

said  a  medical  man  who  was  sent  for  while  he  was  dis 
secting  an  animal.  I  should  not  have  cared  to  be  his 
patient.  His  dissection  would  do  me  no  good,  and  his 
thoughts  would  be  too  much  upon  it.  I  want  a  whole 
man  for  my  doctor,  not  a  half  one.  I  would  have  sent 
for  a  humbler  practitioner,  who  would  have  given  him 
self  entirely  to  me,  and  told  the  other  —  who  was  no 
less  a  man  than  John  Hunter  —  to  go  on  and  finish 
the  dissection  of  his  tiger. 

Sydenham's  "  Read  Don  Quixote "  should  be  ad 
dressed  not  to  the  student,  but  to  the  Professor  of  to« 
day.  Aimed  at  him  it  means,  "  Do  not  be  too  learned* 


294  MEDICAL  ESSAYS. 

Do  not  think  you  are  going  to  lecture  to  picked  young 
men  who  are  training  themselves  to  be  scientific  dis 
coverers.  They  are  of  fair  average  capacity,  and  they 
are  going  to  be  working  doctors.'* 

These  young  men  are  to  have  some  very  serious 
vital  facts  to  deal  with.  I  will  mention  a  few  of  them. 

Every  other  resident  adult  you  meet  in  these  streets 
is  or  will  be  more  or  less  tuberculous.  This  is  not  an 
extravagant  estimate,  as  very  nearly  one  third  of  the 
deaths  of  adults  in  Boston  last  year  were  from  phthi 
sis."  If  the  relative  number  is  less  in  our  other  north 
ern  cities,  it  is  probably  in  a  great  measure  because 
they  are  more  unhealthy ;  that  is,  they  have  as  much, 
or  nearly  as  much,  consumption,  but  they  have  more 
fevers  or  other  fa.tal  diseases. 

These  heavy-eyed  men  with  the  alcoholized  brains, 
these  pallid  youths  with  the  nicotized  optic  ganglia  and 
thinking-marrows  brown  as  their  own  meerschaums,  — 
of  whom  you  meet  too  many,  —  will  ask  all  your  wis 
dom  to  deal  with  their  poisoned  nerves  and  their  en 
feebled  wills. 

Nearly  seventeen  hundred  children  under  five  years 
of  age  died  last  year  in  this  city.  A  poor  human  arti 
cle,  no  doubt,  in  many  cases,  still,  worth  an  attempt  to 
save  them,  especially  when  we  remember  the  effect  of 
Dr.  Clarke's  suggestion  at  the  Dublin  Hospital,  by 
which  some  twenty-five  or  thirty  thousand  children's 
lives  have  probably  been  saved  in  a  single  city. 

Again,  the  complaint  is  often  heard  that  the  native 
population  is  not  increasing  so  rapidly  as  in  former 
generations.  The  breeding  and  nursing  period  of 

•  Total  number  of  deaths,  4379;  under  20  years,  2109;  over 
SO  years,  2270.  From  phthisis,  846;  under  20  years,  146 ;  over 
SO  years,  700. 


SCHOLASTIC   AND   BEDSIDE   TEACHING.  295 

American  women  is  one  of  peculiar  delicacy  and  fre 
quent  infirmity.  Many  of  them  must  require  a  con 
siderable  interval  between  the  reproductive  efforts,  to 
repair  damages  and  regain  strength.  This  matter  is 
not  to  be  decided  by  an  appeal  to  unschooled  nature. 
It  is  the  same  question  as  that  of  the  deformed  pelvis, 
—  one  of  degree.  The  facts  of  mal-vitalization  are  as 
much  to  be  attended  to  as  those  of  mal-formation.  If 
the  woman  with  a  twisted  pelvis  is  to  be  considered 
an  exempt,  the  woman  with  a  defective  organization 
should  be  recognized  as  belonging  to  the  invalid  corps. 
We  shudder  to  hear  what  is  alleged  as  to  the  preva 
lence  of  criminal  practices  ;  if  back  of  these  there  can 
be  shown  organic  incapacity  or  overtaxing  of  too  lim 
ited  powers,  the  facts  belong  to  the  province  of  the 
practical  physician,  as  well  as  of  the  moralist  and  the 
legislator,  and  require  his  gravest  consideration. 

Take  the  important  question  of  bleeding.  Is  vene 
section  done  with  forever  ?  Six  years  ago  it  was  said 
here  in  an  introductory  Lecture  that  it  would  doubt 
less  come  back  again  sooner  or  later.  A  fortnight  ago 
I  found  myself  in  the  cars  with  one  of  the  most  sensi 
ble  and  esteemed  practitioners  in  New  England.  He 
took  out  his  wallet  and  showed  me  two  lancets,  which 
he  carried  with  him ;  he  had  never  given  up  their  use. 
This  is  a  point  you  will  have  to  consider. 

Or,  to  mention  one  out  of  many  questionable  reme 
dies,  shall  you  give  Veratrum  Viride  in  fevers  and  in 
flammations  ?  It  makes  the  pulse  slower  in  these  af 
fections.  Then  the  presumption  would  naturally  be 
that  it  does  harm.  The  caution  with  reference  to  it 
on  this  ground  was  long  ago  recorded  in  the  Lecture 
above  referred  to.  See  what  Dr.  John  Hughes  Ben 
nett  says  of  it  in  the  recent  edition  of  his  work  on 


296  MEDICAL  ESSAYS. 

Medicine.     Nothing  but  the  most  careful  clinical  ex» 
perience  can  settle  this  and  such  points  of  treatment. 

These  are  all  practical  questions  —  questions  of  life 
and  death,  and  every  day  will  be  full  of  just  such 
questions.  Take  the  problem  of  climate.  A  patient 
comes  to  you  with  asthma  and  wants  to  know  where  he 
can  breathe ;  another  comes  to  you  with  phthisis  and 
wants  to  know  where  he  can  live.  What  boy's  play 
is  nine  tenths  of  all  that  is  taught  in  many  a  preten 
tious  course  of  lectures,  compared  with  what  an  accu 
rate  and  extensive  knowledge  of  the  advantages  and 
disadvantages  of  different  residences  in  these  and 
other  complaints  would  be  to  a  practising  physician  1 
I  saw  the  other  day  a  gentleman  living  in  Canada,  who 
had  spent  seven  successive  winters  in  Egypt,  with  the 
entire  relief  of  certain  obscure  thoracic  symptoms 
which  troubled  him  while  at  home.  I  saw,  two  months 
ago,  another  gentleman  from  Minnesota,  an  observer 
and  a  man  of  sense,  who  considered  that  State  as  the 
great  sanatorium  for  all  pulmonary  complaints.  If 
half  our  grown  population  are  or  will  be  more  or  less 
tuberculous,  the  question  of  colonizing  Florida  assumes 
a  new  aspect.  Even  within  the  borders  of  our  own 
State,  the  very  interesting  researches  of  Dr.  Bowditch 
show  that  there  is  a  great  variation  in  the  amount  of 
tuberculous  disease  in  different  towns,  apparently  con 
nected  with  local  conditions.  The  hygienic  map  of  a 
State  is  quite  as  valuable  as  its  geological  map,  and  it 
is  the  business  of  every  practising  physician  to  know 
it  thoroughly.  They  understand  this  in  England,  and 
send  a  patient  with  a  dry  irritating  cough  to  Torquay 
or  Penzance,  while  they  send  another  with  relaxed 
bronchial  membranes  to  Clifton  or  Brighton.  Here  is 
another  great  field  for  practical  study. 


SCHOLASTIC   AND   BEDSIDE  TEACHING.          297 

So  as  to  the  all-important  question  of  diet.  "  Of  all 
the  means  of  cure  at  our  command,"  says  Dr.  Bennett, 
"  a  regulation  of  the  quantity  and  quality  of  the  diet 
is  by  far  the  most  powerful."  Dr.  MacCormac  would 
perhaps  except  the  air  we  breathe,  for  he  thinks  that 
impure  air,  especially  in  sleeping  rooms,  is  the  great 
cause  of  tubercle.  It  is  sufficiently  proved  that  the 
American,  —  the  New  Englander,  —  the  Bostonian,  — 
can  breed  strong  and  sound  children,  generation  after 
generation,  —  nay,  I  have  shown  by  the  record  of  a 
particular  family  that  vital  losses  may  be  retrieved, 
and  a  feeble  race  grow  to  lusty  vigor  in  this  very  cli 
mate  and  locality.  Is  not  the  question  why  our  young 
men  and  women  so  often  break  down,  and  how  they 
can  be  kept  from  breaking  down,  far  more  important 
for  physicians  to  settle  than  whether  there  is  one 
cranial  vertebra,  or  whether  there  are  four,  or  none  ? 

—  But  I  have  a  taste  for  the  homologies,  I  want  to 
go  deeply  into  the  subject  of  embryology,  I  want  to 
analyze  the  protonihilates  precipitated  from  pigeon's 
milk  by  the  action  of  the  lunar  spectrum,  —  shall  I  not 
follow  my  star, —  shall  I  not  obey  my  instinct,  —  shall 
I  not  give  myself  to  the  lofty  pursuits  of  science  for 
its  own  sake  ?  — 

Certainly  you  may,  if  you  like.  But  take  down 
your  sign,  or  never  put  it  up.  That  is  the  way  Dr. 
Owen  and  Dr.  Huxley,  Dr.  Agassiz  and  Dr.  Jeffries 
Wyman,  Dr.  Gray  and  Dr.  Charles  T.  Jackson  settled 
the  difficulty.  We  all  admire  the  achievements  of 
this  band  of  distinguished  doctors  who  do  not  practise. 
But  we  say  of  their  work  and  of  all  pure  science,  as 
the  French  officer  said  of  the  charge  of  the  six  hundred 
at  Balaclava,  "  C'est  magnifique,  mais  ce  n'est  pas  la 
guerre"  — it  is  very  splendid,  but  it  is  not  a  practising 


MEDICAL  ESSAYS. 

doctor's  business.  His  patient  has  a  right  to  the 
cream  of  his  life  and  not  merely  to  the  thin  milk  that 
is  left  after  "  science  "  has  skimmed  it  off.  The  best 
a  physician  can  give  is  never  too  good  for  the  patient. 

It  is  often  a  disadvantage  to  a  young  practitioner  to 
be  known  for  any  accomplishment  outside  of  his  pro 
fession.  Haller  lost  his  election  as  Physician  to  the 
Hospital  in  his  native  city  of  Berne,  principally  on  the 
ground  that  he  was  a  poet.  In  his  later  years  the  phy 
sician  may  venture  more  boldly.  Astruc  was  sixty- 
nine  years  old  when  he  published  his  "  Conjectures," 
the  first  attempt,  we  are  told,  to  decide  the  authorship 
of  the  Pentateuch  showing  anything  like  a  discerning 
criticism.  Sir  Benjamin  Brodie  was  seventy  years  old 
before  he  left  his  physiological  and  surgical  studies  to 
indulge  in  psychological  speculations.  The  period  of 
pupilage  will  be  busy  enough  in  acquiring  the  knowl 
edge  needed,  and  the  season  of  active  practice  will 
leave  little  leisure  for  any  but  professional  studies. 

Dr.  Graves  of  Dublin,  one  of  the  first  clinical  teach 
ers  of  our  time,  always  insisted  on  his  students'  begin 
ning  at  once  to  visit  the  hospital.  At  the  bedside  the 
student  must  learn  to  treat  disease,  and  just  as  cer 
tainly  as  we  spin  out  and  multiply  our  academic  pre 
lections  we  shall  work  in  more  and  more  stuffing,  more 
and  more  rubbish,  more  and  more  irrelevant,  useless 
detail  which  the  student  will  get  rid  of  just  as  soon  as 
he  leaves  us.  Then  the  next  thing  will  be  a  new  or 
ganization,  with  an  examining  board  of  first-rate  prac 
tical  men,  who  will  ask  the  candidate  questions  that 
mean  business, — who  will  make  him  operate  if  he  is  to 
be  a  surgeon,  and  try  him  at  the  bedside  if  he  is  to 
be  a  physician, — and  not  puzzle  him  with  scientific 
conundrums  which  not  more  than  one  of  the  question- 


SCHOLASTIC   AND  BEDSIDE  TEACHING.          299 

ers  eould  answer  himself  or  ever  heard  of  since  he 
graduated. 

Or  these  women  who  are  hammering  at  the  gates  on 
wnich  is  written  "  No  admittance  for  the  mothers  of 
mankind,"  will  by  and  by  organize  an  institution, 
which  starting  from  that  skilful  kind  of  nursing  which 
Florence  Nightingale  taught  so  well,  will  work  back 
wards  through  anodynes,  palliatives,  curatives,  preven 
tives,  until  with  little  show  of  science  it  imparts  most 
of  what  is  most  valuable  in  those  branches  of  the  heal 
ing  art  it  professes  to  teach.  When  that  time  comes, 
the  fitness  of  women  for  certain  medical  duties,  which 
Hecquet  advocated  in  1708,  which  Douglas  maintained 
in  1736,  which  Dr.  John  Ware,  long  the  honored  Pro« 
fessor  of  Theory  and  Practice  in  this  Institution,  up 
held  within  our  own  recollection  in  the  face  of  his  own 
recorded  opinion  to  the  contrary,  will  very  possibly  be 
recognized. 

My  advice  to  every  teacher  less  experienced  than 
myself  would  be,  therefore :  Do  not  fret  over  the  de 
tails  you  have  to  omit ;  you  probably  teach  altogether 
too  many  as  it  is.  Individuals  may  learn  a  thing  with 
once  hearing  it,  but  the  only  way  of  teaching  a  whole 
class  is  by  enormous  repetition,  representation,  and  il 
lustration  in  all  possible  forms.  Now  and  then  you 
will  have  a  young  man  on  your  benches  like  the  late 
Waldo  Burnett,  —  not  very  often,  if  you  lecture  half 
a  century,  You  cannot  pretend  to  lecture  chiefly  for 
men  like  that,  —  a  Mississippi  raft  might  as  well 
take  an  ocean-steamer  in  tow.  To  meet  his  wants 
you  would  have  to  leave  the  rest  of  your  class  behind, 
and  that  you  must  not  do.  President  Allen  of  Jeffer 
son  College  says  that  his  instruction  has  been  success 
ful  in  proportion  as  it  has  been  elementary.  It 


300  MEDICAL  ESSAYS. 

be  a  humiliating  statement,  but  it  is  one  which  I  have 
found  true  in  my  own  experience. 

To  the  student  I  would  say,  that  however  plain  and 
simple  may  be  our  teaching,  he  must  expect  to  forget 
much  which  he  follows  intelligently  in  the  lecture-room. 
But  it  is  not  the  same  as  if  he  had  never  learned  it. 
A  man  must  get  a  thing  before  he  can  forget  it. 
There  is  a  great  world  of  ideas  we  cannot  voluntarily 
recall,  —  they  are  outside  the  limits  of  the  will.  But 
they  sway  our  conscious  thought  as  the  unseen  planets 
influence  the  movements  of  those  within  the  sphere  of 
vision.  No  man  knows  how  much  he  knows,  —  how 
many  ideas  he  has,  —  any  more  than  he  knows  how 
many  blood-globules  roll  in  his  veins.  Sometimes  ac 
cident  brings  back  here  and  there  one,  but  the  mind 
is  full  of  irrevocable  remembrances  and  unthinkable 
thoughts,  which  take  a  part  in  all  its  judgments  as  in 
destructible  forces.  Some  of  you  must  feel  your  scien 
tific  deficiencies  painfully  after  your  best  efforts.  But 
every  one  can  acquire  what  is  most  essential.  A  man 
of  very  moderate  ability  may  be  a  good  physician,  if 
he  devotes  himself  faithfully  to  the  work.  More  than 
this,  a  positively  dull  man,  in  the  ordinary  acceptation 
of  the  term,  sometimes  makes  a  safer  practitioner  than 
one  who  has,  we  will  say,  five  per  cent,  more  brains 
than  his  average  neighbor,  but  who  thinks  it  is  fifty 
per  cent.  more.  Skulls  belonging  to  this  last  variety 
of  the  human  race  are  more  common,  I  may  remark, 
than  specimens  like  the  Neanderthal  cranium,  a  cast 
of  which  you  will  find  on  the  table  in  the  Museum. 

Whether  the  average  talent  be  high  or  low,  the  Col- 
leges  of  the  land  must  make  the  best  commodity  they 
can  out  of  such  material  as  the  country  and  the  cities 
furnish  them.  The  community  must  have  Doctors  as 


SCHOLASTIC  AND  BEDSIDE  TEACHING.          301 

it  must  have  bread.  It  uses  up  its  Doctors  just  as  it 
wears  out  its  shoes,  and  requires  new  ones.  All  the 
bread  need  not  be  French  rolls,  all  the  shoes  need  not 
be  patent  leather  ones ;  but  the  bread  must  be  some 
thing  that  can  be  eaten,  and  the  shoes  must  be  some 
thing  that  can  be  worn.  Life  must  somehow  find  food 
for  the  two  forces  that  rub  everything  to  pieces,  or 
burn  it  to  ashes,  —  friction  and  oxygen.  Doctors  are 
oxydable  products,  and  the  schools  must  keep  furnish 
ing  new  ones  as  the  old  ones  turn  into  oxyds ;  some 
of  first-rate  quality  that  burn  with  a  great  light,  — 
some  of  a  lower  grade  of  brilliancy,  some  honestly, 
unmistakably,  by  the  grace  of  God,  of  moderate  gifts, 
or  in  simpler  phrase,  dull. 

The  public  will  give  every  honest  and  reasonably 
competent  worker  in  the  healing  art  a  hearty  welcome. 
It  is  on  the  whole  very  loyal  to  the  Medical  Profes 
sion.  Three  successive  years  have  borne  witness  to  the 
feeling  with  which  this  Institution,  representing  it  in  its 
educational  aspect,  is  regarded  by  those  who  are  them 
selves  most  honored  and  esteemed.  The  great  Master 
of  Natural  Science  bade  the  last  year's  class  farewell 
in  our  behalf,  in  those  accents  which  delight  every 
audience.  The  Head  of  our  ancient  University  hon 
ored  us  in  the  same  way  in  the  preceding  season.  And 
how  can  we  forget  that  other  occasion  when  the  Chief 
Magistrate  of  the  Commonwealth,  that  noble  citizen 
whom  we  have  just  lost,  large-souled,  sweet-natured, 
always  ready  for  every  kind  office,  came  among  us  at 
our  bidding,  and  talked  to  us  of  our  duties  in  words  as 
full  of  wisdom  as  his  heart  was  of  goodness  ? 

You  have  not  much  to  fear,  I  think,  from  the  fancy 
practitioners.  The  vulgar  quackeries  drop  off,  atro 
phied,  one  after  another.  Homoeopathy  has  long  been 


802  MEDICAL  ESSAYS. 

encysted,  and  is  carried  on  the  body  medical  as  quietly 
as  an  old  wen.  Every  year  gives  you  a  more  reason 
ing  and  reasonable  people  to  deal  with.  See  how  it  is 
in  Literature.  The  dynasty  of  British  dogmatists, 
after  lasting  a  hundred  years  and  more,  is  on  its  last 
legs.  Thomas  Carlyle,  third  in  the  line  of  descent, 
finds  an  audience  very  different  from  those  which  lis 
tened  to  the  silver  speech  of  Samuel  Taylor  Coleridge 
and  the  sonorous  phrases  of  Samuel  Johnson.  We 
read  him,  we  smile  at  his  clotted  English,  his  "  swarm- 
ery"  and  other  picturesque  expressions,  but  we  lay 
down  his  tirade  as  we  do  one  of  Dr.  Cumming's  inter 
pretations  of  prophecy,  which  tells  us  that  the  world  is 
coming  to  an  end  next  week  or  next  month,  if  the 
weather  permits,  —  not  otherwise,  —  feeling  very  sure 
that  the  weather  will  be  unfavorable. 

It  is  the  same  common-sense  public  you  will  appeal 
to.  The  less  pretension  you  make,  the  better  they  will 
like  you  in  the  long  run.  I  hope  we  shall  make  every 
thing  as  plain  and  as  simple  to  you  as  we  can.  I 
would  never  use  a  long  word,  even,  where  a  short  one 
would  answer  the  purpose.  I  know  there  are  profess 
ors  in  this  country  who  "ligate"  arteries.  Other 
surgeons  only  tie  them,  and  it  stops  the  bleeding  just 
as  well.  It  is  the  familiarity  and  simplicity  of  bed 
side  instruction  which  makes  it  so  pleasant  as  well  as 
so  profitable.  A  good  clinical  teacher  is  himself  a 
Medical  School.  We  need  not  wonder  that  our  young 
men  are  beginning  to  announce  themselves  not  only  as 
graduates  of  this  or  that  College,  but  also  as  pupils  of 
some  one  distinguished  master. 

I  wish  to  close  this  Lecture,  if  you  will  allow  me 
a  few  moments  longer,  with  a  brief  sketch  of  an  in 
structor  and  practitioner  whose  character  was  as  nearly 


SCHOLASTIC   AND  BEDSIDE  TEACHING.          303 

a  model  one  in  both  capacities  as  I  can  find  anywhere 
recorded. 

Dr.  JAMES  JACKSON,  Professor  of  the  Theory  and 
Practice  of  Medicine  in  this  University  from  1812  to 
1846,  and  whose  name  has  been  since  retained  on  our 
rolls  as  Professor  Emeritus,  died  on  the  27th  of  August 
last,  in  the  ninetieth  year  of  his  age.  He  studied  his 
profession,  as  I  have  already  mentioned,  with  Dr.  Hoi- 
yoke  of  Salem,  one  of  the  few  physicians  who  have 
borne  witness  to  their  knowledge  of  the  laws  of  life 
by  living  to  complete  their  hundredth  year.  I  think 
the  student  took  his  Old  Master,  as  he  always  loved 
to  call  him,  as  his  model;  each  was  worthy  of  the 
other,  and  both  were  bright  examples  to  all  who  come 
after  them. 

I  remember  that  in  the  sermon  preached  by  Dr. 
Brazer  after  Dr.  Holyoke's  death,  one  of  the  points 
most  insisted  upon  as  characteristic  of  that  wise  and 
good  old  man  was  the  perfect  balance  of  all  his  facul 
ties.  The  same  harmonious  adjustment  of  powers,  the 
same  symmetrical  arrangement  of  life,  the  same  com 
plete  fulfilment  of  every  day's  duties,  without  haste 
and  without  needless  delay,  which  characterized  the 
master,  equally  distinguished  the  scholar.  A  glance  at 
the  life  of  our  own  Old  Master,  if  I  can  do  any  justice 
at  all  to  his  excellences,  will  give  you  something  to 
carry  away  from  this  hour's  meeting  not  unworthy  to 
be  remembered. 

From  December,  1797,  to  October,  1799,  he  remained 
with  Dr.  Holyoke  as  a  student,  a  period  which  he  has 
spoken  of  as  a  most  interesting  and  most  gratifying 
part  of  his  life.  After  this  he  passed  eight  months  in 
London,  and  on  his  return,  in  October,  1800,  he  began 
business  in  Boston. 


304  MEDICAL  ESSAYS. 

He  had  followed  Mr.  Cline,  as  I  have  mentioned, 
and  was  competent  to  practise  Surgery.  But  he  found 
Dr.  John  Collins  Warren  had  already  occupied  the 
ground  which  at  that  day  hardly  called  for  more  than 
one  leading  practitioner,  and  wisely  chose  the  Medical 
branch  of  the  profession.  He  had  only  himself  to  rely 
upon,  but  he  had  confidence  in  his  prospects,  conscious, 
doubtless,  of  his  own  powers,  knowing  his  own  industry 
and  determination,  and  being  of  an  eminently  cheerful 
and  hopeful  disposition.  No  better  proof  of  his  spirit 
can  be  given  than  that,  just  a  year  from  the  time  when 
he  began  to  practise  as  a  physician,  he  took  that  event 
ful  step  which  in  such  a  man  implies  that  he  sees  his 
way  clear  to  a  position ;  he  married  a  lady  blessed  with 
many  gifts,  but  not  bringing  him  a  fortune  to  paralyze 
his  industry. 

He  had  not  miscalculated  his  chances  in  life.  He 
very  soon  rose  into  a  good  practice,  and  began  the 
founding  of  that  reputation  which  grew  with  his  years, 
until  he  stood  by  general  consent  at  the  head  of  his 
chosen  branch  of  the  profession,  to  say  the  least,  in 
this  city  and  in  all  this  region  of  country.  His  skill 
and  wisdom  were  the  last  tribunal  to  which  the  sick 
and  suffering  could  appeal.  The  community  trusted 
and  loved  him,  the  profession  recognized  him  as  the 
noblest  type  of  the  physician.  The  young  men  whom 
he  had  taught  wandered  through  foreign  hospitals, 
where  they  learned  many  things  that  were  valuable, 
and  many  that  were  curious ;  but  as  they  grew  older 
and  began  to  think  more  of  their  ability  to  help  the 
sick  than  their  power  of  talking  about  phenomena, 
they  began  to  look  back  to  the  teaching  of  Dr.  Jack 
son,  as  he,  after  his  London  experience,  looked  back 
*o  that  of  Dr.  Holyoke.  And  so  it  came  to  be  at  last 


SCHOLASTIC  AND    BEDSIDE  TEACHING.          305 

that  the  bare  mention  of  his  name  in  any  of  our  medi 
cal  assemblies  would  call  forth  such  a  tribute  of  affec 
tionate  regard  as  is  only  yielded  to  age  when  it  brings 
with  it  the  record  of  a  life  spent  in  well  doing. 

No  accident  ever  carries  a  man  to  eminence  such  as 
his  in  the  medical  profession.  He  who  looks  for  it 
must  want  it  earnestly  and  work  for  it  vigorously ; 
Nature  must  have  qualified  him  in  many  ways,  and 
education  must  have  equipped  him  with  various  knowl 
edge,  or  his  reputation  will  evaporate  before  it  reaches 
the  noon-day  blaze  of  fame.  How  did  Dr.  Jackson 
gain  the  position  which  all  conceded  to  him  ?  In  the 
answer  to  this  question  some  among  you  may  find  a 
key  that  shall  unlock  the  gate  opening  on  that  fair 
field  of  the  future  of  which  all  dream  but  which  not 
all  will  ever  reach. 

First  of  all,  he  truly  loved  his  profession.  He  had 
no  intellectual  ambitions  outside  of  it,  literary,  scien 
tific  or  political.  To  him  it  was  occupation  enough  to 
apply  at  the  bedside  the  best  of  all  that  he  knew  for 
the  good  of  his  patient;  to  protect  the  community 
against  the  inroads  of  pestilence ;  to  teach  the  young 
all  that  he  himself  had  been  taught,  with  all  that  his 
own  experience  had  added ;  to  leave  on  record  some 
of  the  most  important  results  of  his  long  observation. 

With  his  patients  he  was  so  perfect  at  all  points 
that  it  is  hard  to  overpraise  him.  I  have  seen  many 
noted  British  and  French  and  American  practitioners, 
but  I  never  saw  the  man  so  altogether  admirable  at 
the  bedside  of  the  sick  as  Dr.  James  Jackson.  His 
smile  was  itself  a  remedy  better  than  the  potable  gold 
and  the  dissolved  pearls  that  comforted  the  praecordia 
of  mediaeval  monarchs.  Did  a  patient,  alarmed  with 
out  cause,  need  encouragement,  it  carried  the  sunshine 


806  MEDICAL  ESSAYS. 

of  hope  into  his  heart  and  put  all  his  whims  to  flight, 
as  David's  harp  cleared  the  haunted  chamber  of  the 
sullen  king.  Had  the  hour  come,  not  for  encourage 
ment,  but  for  sympathy,  his  face,  his  voice,  his  manner 
all  showed  it,  because  his  heart  felt  it.  So  gentle  was 
he,  so  thoughtful,  so  calm,  so  absorbed  in  the  case  be 
fore  him,  not  to  turn  round  and  look  for  a  tribute  to 
his  sagacity,  not  to  bolster  himself  in  a  favorite  theory, 
but  to  find  out  all  he  could,  and  to  weigh  gravely  and 
cautiously  all  that  he  found,  that  to  follow  him  in  his 
morning  visit  was  not  only  to  take  a  lesson  in  the  heal 
ing  art,  it  was  learning  how  to  learn,  how  to  move, 
how  to  look,  how  to  feel,  if  that  can  be  learned.  To 
visit  with  Dr.  Jackson  was  a  medical  education. 

He  was  very  firm,  with  all  his  kindness.  He  would 
have  the  truth  about  his  patients.  The  nurses  found 
it  out;  and  the  shrewder  ones  never  ventured  to  tell 
him  anything  but  a  straight  story.  A  clinical  dialogue 
between  Dr.  Jackson  and  Miss  Rebecca  Taylor,  some 
time  nurse  in  the  Massachusetts  General  Hospital,  a 
mistress  in  her  calling,  was  as  good  questioning  and 
answering  as  one  would  be  like  to  hear  outside  of  the 
court-room. 

Of  his  practice  you  can  form  an  opinion  from  his 
book  called  "  Letters  to  a  Young  Physician."  Like 
all  sensible  men  from  the  days  of  Hippocrates  to  the 
present,  he  knew  that  diet  and  regimen  were  more  im 
portant  than  any  drug  or  than  all  drugs  put  together. 
Witness  his  treatment  of  phthisis  and  of  epilepsy.  He 
retained,  however,  more  confidence  in  some  remedial 
agents  than  most  of  the  younger  generation  would  con 
cede  to  them.  Yet  his  materia  medica  was  a  simple 
one. 

"  When  I  first  went  to  live  with  Dr.  Holyoke,"  he 


SCHOLASTIC   AND   BEDSIDE   TEACHING.  307 

Bays,  "  in  1797,  showing  me  his  shop,  he  said,  '  There 
seems  to  you  to  be  a  great  variety  of  medicines  here, 
and  that  it  will  take  you  long  to  get  acquainted  with 
them,  but  most  of  them  are  unimportant.  There  are 
four  which  are  equal  to  all  the  rest,  namely,  Mercury, 
Antimony,  Bark  and  Opium.' "  And  Dr.  Jackson 
adds,  "I  can  only  say  of  his  practice,  the  longer  I 
have  lived,  I  have  thought  better  and  better  of  it." 
When  he  thought  it  necessary  to  give  medicine,  he 
gave  it  in  earnest.  He  hated  half -practice  —  giving  a 
little  of  this  or  that,  so  as  to  be  able  to  say  that  one 
had  done  something,  in  case  a  consultation  was  held, 
or  a  still  more  ominous  event  occurred.  He  would 
give  opium,  for  instance,  as  boldly  as  the  late  Dr. 
Fisher  of  Beverly,  but  he  followed  the  aphorism  of  the 
Father  of  Medicine,  and  kept  extreme  remedies  for 
extreme  cases. 

When  it  came  to  the  "  non-naturals,"  as  he  would 
sometimes  call  them,  after  the  old  physicians,  —  name 
ly,  air,  meat  and  drink,  sleep  and  watching,  motion 
and  rest,  the  retentions  and  excretions,  and  the  affec 
tions  of  the  mind,  —  he  was,  as  I  have  said,  of  the 
school  of  sensible  practitioners,  in  distinction  from 
that  vast  community  of  quacks,  with  or  without  the 
diploma,  who  think  the  chief  end  of  man  is  to  support 
apothecaries,  and  are  never  easy  until  they  can  get 
every  patient  upon  a  regular  course  of  something  nasty 
or  noxious.  Nobody  was  so  precise  in  his  directions 
about  diet,  airs  and  exercise,  as  Dr.  Jackson.  He  had 
the  same  dislike  to  the  dpeupres,  the  about  so  much, 
about  so  often,  about  so  long,  which  I  afterwards 
found  among  the  punctilious  adherents  of  the  numeri« 
cal  system  at  La  Pitie*. 

He  used  to  insist  on  one  small  point  with  a  certain 


808  MEDICAL  ESSAYS. 

philological  precision,  namely,  the  true  meaning  of  the 
word  "  cure."  He  would  have  it  that  to  cure  a  pa 
tient  was  simply  to  care  for  him.  I  refer  to  it  as 
showing  what  his  idea  was  of  the  relation  of  the  physi 
cian  to  the  patient.  It  was  indeed  to  care  for  him,  as 
if  his  life  were  bound  up  in  him,  to  watch  his  incom 
ings  and  outgoings,  to  stand  guard  at  every  avenue 
that  disease  might  enter,  to  leave  nothing  to  chance ; 
not  merely  to  throw  a  few  pills  and  powders  into  one 
pan  of  the  scales  of  Fate,  while  Death  the  skeleton 
was  seated  in  the  other,  but  to  lean  with  his  whole 
weight  on  the  side  of  life,  and  shift  the  balance  in  its 
favor  if  it  lay  in  human  power  to  do  it.  Such  devo 
tion  as  this  is  only  to  be  looked  for  in  the  man  who 
gives  himself  wholly  up  to  the  business  of  healing, 
who  considers  Medicine  itself  a  Science,  or  if  not  a 
science,  is  willing  to  follow  it  as  an  art,  —  the  noblest 
of  arts,  which  the  gods  and  demigods  of  ancient  relig 
ions  did  not  disdain  to  practise  and  to  teach. 

The  same  zeal  made  him  always  ready  to  listen  to 
any  new  suggestion  which  promised  to  be  useful,  at  a 
period  of  life  when  many  men  find  it  hard  to  learn 
new  methods  and  accept  new  doctrines.  Few  of  his 
generation  became  so  accomplished  as  he  in  the  arts  of 
direct  exploration  ;  coming  straight  from  the  Parisian 
experts,  I  have  examined  many  patients  with  him,  and 
have  had  frequent  opportunities  of  observing  his  skill 
in  percussion  and  auscultation. 

One  element  in  his  success,  a  trivial  one  compared 
with  others,  but  not  to  be  despised,  was  his  punctual' 
ity.  He  always  carried  two  watches,  —  1  doubt  if  he 
told  why,  any  more  than  Dr.  Johnson  told  what  he  did 
with  the  orange-peel,  —  but  probably  with  reference  to 
this  virtue.  He  was  as  much  to  be  depended  upon  at 


SCHOLASTIC   AND   BEDSIDE  TEACHING.          309 

the  appointed  time  as  the  solstice  or  the  equinox. 
There  was  another  point  I  have  heard  him  speak  of  as 
an  important  rule  with  him ;  to  come  at  the  hour  when 
he  was  expected  ;  if  he  had  made  his  visit  for  several 
days  successively  at  ten  o'clock,  for  instance,  not  to 
put  it  off,  if  he  could  possibly  help  it,  until  eleven,  and 
so  keep  a  nervous  patient  and  an  anxious  family  wait 
ing  for  him  through  a  long,  weary  hour. 

If  I  should  attempt  to  characterize  his  teaching,  I 
should  say  that  while  it  conveyed  the  best  results  of 
his  sagacious  and  extended  observation,  it  was  singu 
larly  modest,  cautious,  simple,  sincere.  Nothing  was 
for  show,  for  self-love ;  there  was  no  rhetoric,  no  dec 
lamation,  no  triumphant  "  I  told  you  so,"  but  the 
plain  statement  of  a  clear-headed  honest  man,  who 
knows  that  he  is  handling  one  of  the  gravest  subjects 
that  interest  humanity.  His  positive  instructions  were 
full  of  value,  but  the  spirit  in  which  he  taught  inspired 
that  loyal  love  of  truth  which  lies  at  the  bottom  of  all 
real  excellence. 

I  will  not  say  that,  during  his  long-  career,  Dr.  Jack 
son  never  made  an  enemy.  I  have  heard  him  tell  how, 
in  his  very  early  days,  old  Dr.  Danforth  got  into  a 
towering  passion  with  him  about  some  professional 
consultation,  and  exploded  a  monosyllable  or  two  of 
the  more  energetic  kind  on  the  occasion.  I  remember 
that  that  somewhat  peculiar  personage,  Dr.  Water- 
house,  took  it  hardly  when  Dr.  Jackson  succeeded  to 
his  place  as  Professor  of  Theory  and  Practice.  A 
young  man  of  Dr.  Jackson's  talent  and  energy  could 
hardly  take  the  position  that  belonged  to  him  without 
crowding  somebody  in  a  profession  where  three  in  a 
bed  is  the  common  rule  of  the  household.  But  he  was 
ft  peaceful  man  and  a  peace-maker  all  his  days.  No 


810  MEDICAL  ESSAYS. 

man  ever  did  more,  if  so  much,  to  produce  and  main 
tain  the  spirit  of  harmony  for  which  we  consider  oul 
medical  community  as  somewhat  exceptionally  distin 
guished. 

If  this  harmony  should  ever  be  threatened,  I  could 
wish  that  every  impatient  and  irritable  member  of  the 
profession  would  read  that  beautiful,  that  noble  Pref 
ace  to  the  "  Letters,"  addressed  to  John  Collins  War 
ren.  I  know  nothing  finer  in  the  medical  literature  of 
all  tune  than  this  Prefatory  Introduction.  It  is  a 
golden  prelude,  fit  to  go  with  the  three  great  Prefaces 
which  challenge  the  admiration  of  scholars,  —  Calvin's 
to  his  Institutes,  De  Thou's  to  his  History,  and  Casau- 
bon's  to  his  Polybius,  —  not  because  of  any  learning 
or  rhetoric,  though  it  is  charmingly  written,  but  for  a 
spirit  flowing  through  it  to  which  learning  and  rhet 
oric  are  but  as  the  breath  that  is  wasted  on  the  air  to 
the  blood  that  warms  the  heart. 

Of  a  similar  character  is  this  short  extract  which  I 
am  permitted  to  make  from  a  private  letter  of  his  to 
a  dear  young  friend.  He  was  eighty-three  years  old 
at  the  time  of  writing  it. 

"  I  have  not  loved  everybody  whom  I  have  known, 
but  I  have  striven  to  see  the  good  points  in  the  char 
acters  of  all  men  and  women.  At  first  I  must  have 
done  this  from  something  in  my  own  nature,  for  I  was 
not  aware  of  it,  and  yet  was  doing  it  without  any  plan, 
when  one  day,  sixty  years  ago,  a  friend  whom  I  loved 
and  respected  said  this  to  me,  c  Ah,  James,  I  see  that 
you  are  destined  to  succeed  in  the  world,  and  to  make 
friends,  because  you  are  so  ready  to  see  the  good  points 
in  the  characters  of  those  you  meet.'  " 

I  close  this  imperfect  notice  of  some  features  in  the 
character  of  this  most  honored  and  beloved  of  physi- 


SCHOLASTIC   AND   BEDSIDE  TEACHING.          311 

cians  by  applying  to  him  the  words  which  were  writ 
ten  of  William  Heberden,  whose  career  was  not  unlike 
his  own,  and  who  lived  to  the  same  patriarchal  age. 

"  From  his  early  youth  he  had  always  entertained  a 
deep  sense  of  religion,  a  consummate  love  of  virtue, 
an  ardent  thirst  after  knowledge,  and  an  earnest  de 
sire  to  promote  the  welfare  and  happiness  of  all  man 
kind.  By  these  qualities,  accompanied  with  great 
sweetness  of  manners,  he  acquired  the  love  and  esteem 
of  all  good  men,  in  a  degree  which  perhaps  very  few 
have  experienced;  and  after  passing  an  active  life 
with  the  uniform  testimony  of  a  good  conscience,  he 
became  an  eminent  example  of  its  influence,  in  the 
cheerfulness  and  serenity  of  his  latest  age." 

Such  was  the  man  whom  I  offer  to  you  as  a  model, 
young  gentlemen,  at  the  outset  of  your  medical  career. 
I  hope  that  many  of  you  will  recognize  some  traits  of 
your  own  special  teachers  scattered  through  various 
parts  of  the  land  in  the  picture  I  have  drawn.  Let 
me  assure  you  that  whatever  you  may  learn  in  this  or 
any  other  course  of  public  lectures,  —  and  I  trust  you 
will  learn  a  great  deal,  —  the  daily  guidance,  counsel, 
example,  of  your  medical  father,  for  such  the  Oath  of 
Hippocrates  tells  you  to  consider  your  preceptor,  will, 
if  he  is  in  any  degree  like  him  of  whom  I  have  spoken, 
be  the  foundation  on  which  all  that  we  teach  is  reared, 
and  perhaps  outlive  most  of  our  teachings,  as  in  Dr. 
Jackson's  memory  the  last  lessons  that  remained  with 
him  were  those  of  his  Old  Master. 


VI. 


THE  MEDICAL  PROFESSION  IN  MASSACHUSETTS,  o 

THE  medical  history  of  eight  generations,  told  in  ail 
hour,  must  be  in  many  parts  a  mere  outline.  The  de 
tails  I  shall  give  will  relate  chiefly  to  the  first  century. 
I  shall  only  indicate  the  leading  occurrences,  with  the 
more  prominent  names  of  the  two  centuries  which  fol 
low,  and  add  some  considerations  suggested  by  the  facts 
which  have  been  passed  in  review. 

A  geographer  who  was  asked  to  describe  the  tides  of 
Massachusetts  Bay,  would  have  to  recognize  the  cir 
cumstance  that  they  are  a  limited  manifestation  of 
a  great  oceanic  movement.  To  consider  them  apart 
from  this,  would  be  to  localize  a  planetary  phenome 
non,  and  to  provincialize  a  law  of  the  universe.  The 
art  of  healing  in  Massachusetts  has  shared  more  or  less 
fully  and  readily  the  movement  which,  with  its  periods 
of  ebb  and  flow,  has  been  raising  its  level  from  age  to 
age  throughout  the  better  part  of  Christendom.  Its 
practitioners  brought  with  them  much  of  the  knowledge 
and  many  of  the  errors  of  the  Old  World  ;  they  have 
always  been  in  communication  with  its  wisdom  and  its 
folly ;  it  is  not  without  interest  to  see  how  far  the  new 
conditions  in  which  they  found  themselves  have  been 
favorable  or  unfavorable  to  the  growth  of  sound  medi 
cal  knowledge  and  practice. 

•  A  Lecture  of  a  Course  by  members  of  the  Massachusetts 
Historical  Society,  delivered  before  the  Lowell  Institute,  Jan 
uary  29,  1869. 


THE  MEDICAL  PROFESSION   IN  MASSACHUSETTS.   313 

The  state  of  medicine  is  an  index  of  the  civilization 
*>f  an  age  and  country,  —  one  of  the  best,  perhaps,  by 
which  it  can  be  judged.  Surgery  invokes  the  aid  of 
all  the  mechanical  arts.  From  the  rude  violences  of 
the  age  of  stone,  —  a  relic  of  which  we  may  find  in 
the  practice  of  Zipporah,  the  wife  of  Moses,a —  to  the 
delicate  operations  of  to-day  upon  patients  lulled  into 
temporary  insensibility,  is  a  progress  which  presup 
poses  a  skill  in  metallurgy  and  in  the  labors  of  the 
workshop  and  the  laboratory  it  has  taken  uncounted 
generations  to  accumulate.  Before  the  morphia  which 
deadens  the  pain  of  neuralgia,  or  the  quinine  which 
arrests  the  fit  of  an  ague,  can  find  their  place  in  our 
pharmacies,  commerce  must  have  perfected  its  ma 
chinery,  and  science  must  have  refined  its  processes, 
through  periods  only  to  be  counted  by  the  life  of  na 
tions.  Before  the  means  which  nature  and  art  have 
put  in  the  hands  of  the  medical  practitioner  can  be 
fairly  brought  into  use,  the  prejudices  of  the  vulgar 
must  be  overcome,  the  intrusions  of  false  philosophy 
must  be  fenced  out,  and  the  partnership  with  the  priest 
hood  dissolved.  All  this  implies  that  freedom  and  ac 
tivity  of  thought  which  belong  only  to  the  most  ad 
vanced  conditions  of  society  ;  and  the  progress  towards 
this  is  by  gradations  as  significant  of  wide-spread 
changes,  as  are  the  varying  states  of  the  barometer 
of  far-extended  conditions  of  the  atmosphere. 

Apart,  then,  from  its  special  and  technical  interest, 
my  subject  has  a  meaning  which  gives  a  certain  im 
portance,  and  even  dignity,  to  details  in  themselves 
trivial  and  almost  unworthy  of  record.  A  medical 
entry  in  Governor  Winthrop's  journal  may  seem  at 
first  sight  a  mere  curiosity ;  but,  rightly  interpreted,  it 
Exodus  iv.  25. 


314  MEDICAL  ESSAYS. 

is  a  key  to  his  whole  system  of  belief  as  to  the  order 
of  the  universe  and  the  relations  between  man  and  hia 
Maker.  Nothing  sheds  such  light  on  the  superstitions 
of  an  age  as  the  prevailing  interpretation  and  treat 
ment  of  disease.  When  the  touch  of  a  profligate 
monarch  was  a  cure  for  one  of  the  most  inveterate  of 
maladies,  when  the  common  symptoms  of  hysteria  were 
prayed  over  as  marks  of  demoniacal  possession,  we 
might  well  expect  the  spiritual  realms  of  thought  to  be 
peopled  with  still  stranger  delusions. 

Let  us  go  before  the  Pilgrims  of  the  Mayflower,  and 
look  at  the  shores  on  which  they  were  soon  to  land.  A 
wasting  pestilence  had  so  thinned  the  savage  tribes 
that  it  was  sometimes  piously  interpreted  as  having 
providentially  prepared  the  way  for  the  feeble  band  of 
exiles.  Cotton  Mather,  who,  next  to  the  witches,  hated 
the  "tawnies,"  "  wild  beasts,"  "blood-hounds,"  "rat 
tlesnakes,"  "infidels,"  as  in  different  places  he  calls 
the  unhappy  Aborigines,  describes  the  condition  of 
things  in  his  lively  way,  thus:  — 

"  The  Indians  in  these  Parts  had  newly,  even  about 
a  Year  or  Two  before,  been  visited  with  such  a  prodi 
gious  Pestilence;  as  carried  away  not  a  Tenth,  but 
Nine  Parts  of  Ten  (yea  't  is  said  Nineteen  of  Twenty^) 
among  them :  so  that  the  Woods  were  almost  cleared 
of  those  pernicious  Creatures  to  make  Room  for  a  bet 
ter  Growth"  a 

What  this  pestilence  was  has  been  much  discussed. 
It  is  variously  mentioned  by  different  early  writers  as 
w  the  plague,"  "  a  great  and  grievous  plague,"  "  a  sore 
consumption,"  as  attended  with  spots  which  left  un- 
healed  places  on  those  who  recovered,  as  making  the 
"  Magnalia,  book  i.  chap.  2. 


THE   MEDICAL   PROFESSION   IN   MASSACHUSETTS.    315 

whole  surface  yellow  as  with  a  garment."  Perhaps  no 
disease  answers  all  these  conditions  so  well  as  small 
pox.  We  know  from  different  sources  what  frightful 
havoc  it  made  among  the  Indians  in  after  years,  —  in 
1631,  for  instance,  when  it  swept  away  the  aboriginal 
inhabitants  of  whole  towns,6  and  in  1633."  We  have 
seen  a  whole  tribe,  the  Mandans,  extirpated  by  it  in 
our  own  day.  The  word  "plague"  was  used  very 
vaguely,  as  in  the  description  of  the  "  great  sickness  " 
found  among  the  Indians  by  the  expedition  of  1622.d 
This  same  great  sickness  could  hardly  have  been  yel 
low  fever,  as  it  occurred  in  the  month  of  November. 
I  cannot  think,  therefore,  that  either  the  scourge  of 
the  East  or  our  Southern  malarial  pestilence  was  the 
disease  that  wasted  the  Indians.  As  for  the  yellow 
ness  like  a  garment,  that  is  too  familiar  to  the  eyes  of 
all  who  have  ever  looked  on  the  hideous  mask  of  con 
fluent  variola. 

Without  the  presence  or  the  fear  of  these  exotic 
maladies,  the  forlorn  voyagers  of  the  Mayflower  had 
sickness  enough  to  contend  with.  At  their  first  land 
ing  at  Cape  Cod,  gaunt  and  hungry  and  longing  for 
fresh  food,  they  found  upon  the  sandy  shore  "great 
mussels,  and  very  fat  and  full  of  sea-pearl."  Sailors 
and  passengers  indulged  in  the  treacherous  delicacy, 
which  seems  to  have  been  the  sea-clam;  and  found 
that  these  mollusks,  like  the  shell  the  poet  tells  of, 
remembered  their  august  abode,  and  treated  the  way 
worn  adventurers  to  a  gastric  reminiscence  of  the  heav 
ing  billows.  In  the  mean  time  it  blew  and  snowed 

•  Young,  Chronicles  of  the  Pilgrims,  p.  183,  note. 
6  Holmes's  Annals,  voL  i.  p.  211,  note. 
c  Young,  Chronicles  of  Massachusetts,  p.  886. 
d  Chronicles  of  the  Pilgrims,  p.  302. 


816  MEDICAL  ESSAYS. 

and  froze.*  The  water  turned  to  ice  on  their  clothes, 
and  made  them  many  times  like  coats  of  iron.  Ed 
ward  Tilley  had  like  to  have  "  sounded "  with  cold. 
The  gunner,  too,  was  sick  unto  death,  but  "  hope  of 
trucking  "  kept  him  on  his  feet,  —  a  Yankee,  it  should 
seem,  when  he  first  touched  the  shore  of  New  England. 
Most,  if  not  all,  got  colds  and  coughs,  which  after 
wards  turned  to  scurvy,  whereof  many  died.6 

How  can  we  wonder  that  the  crowded  and  tempest- 
tossed  voyagers,  many  of  them  already  suffering,  should 
have  fallen  before  the  trials  of  the  first  winter  in  Plym 
outh  ?  Their  imperfect  shelter,  their  insufficient  sup 
ply  of  bread,  their  salted  food,  now  in  unwholesome 
condition,  account  too  well  for  the  diseases  and  the 
mortality  that  marked  this  first  dreadful  season ;  weak 
ness,  swelling  of  the  limbs,  and  other  signs  of  scurvy, 
betrayed  the  want  of  proper  nourishment  and  protec 
tion  from  the  elements.  In  December  six  of  their 
number  died,  in  January  eight,  in  February,  seven 
teen,  in  March  thirteen.  With  the  advance  of  spring 
the  mortality  diminished,  the  sick  and  lame  began  to 
recover,  and  the  colonists,  saddened  but  not  disheart 
ened,  applied  themselves  to  the  labors  of  the  opening 
year.' 

One  of  the  most  pressing  needs  of  the  early  colonists 
must  have  been  that  of  physicians  and  surgeons.  In 
Mr.  Savage's  remarkable  Genealogical  Dictionary  of 
the  first  settlers  who  came  over  before  1692  and  their 
descendants  to  the  third  generation,  I  find  scattered 
through  the  four  crowded  volumes  the  names  of  one 
hundred  and  thirty-four  medical  practitioners.  Of 

•  Chronicles  of  the  Pilgrims,  p.  119. 
Ibid.  pp.  138,  151.  •  Ibid.  p.  198. 


THE  MEDICAL   PROFESSION   IN   MASSACHUSETTS.    317 

these,  twelve,  and  probably  many  more,  practised  sur* 
gery;  three  were  barber-surgeons.  A  little  incident 
throws  a  glimmer  from  the  dark  lantern  of  memory 
upon  William  Dinely,  one  of  these  practitioners  with 
the  razor  and  the  lancet.  He  was  lost  between  Boston 
and  Roxbury  in  a  violent  tompest  of  wind  and  snow ; 
ten  days  afterwards  a  son  was  born  to  his  widow,  and 
with  a  touch  of  homely  sentiment,  I  had  almost  said 
poetry,  they  called  the  little  creature  "  Fathergone " 
Dinely.  Six  or  seven,  probably  a  larger  number,  were 
ministers  as  well  as  physicians,  one  of  whom,  I  am 
sorry  to  say,  took  to  drink  and  tumbled  into  the  Con 
necticut  River,  and  so  ended.  One  was  not  only  doc 
tor,  but  also  schoolmaster  and  poet.  One  practised 
medicine  and  kept  a  tavern.  One  was  a  butcher,  but 
calls  himself  a  surgeon  in  his  will,  a  union  of  callings 
which  suggests  an  obvious  pleasantry.  One  female 
practitioner,  employed  by  her  own  sex,  —  Ann  Moore, 
—  was  the  precursor  of  that  intrepid  sisterhood  whose 
cause  it  has  long  been  my  pleasure  and  privilege  to 
advocate  on  all  fitting  occasions. 

Outside  of  this  list  I  must  place  the  name  of  Thomas 
Wilkinson,  who  was  complained  of,  in  1676,  for  prac 
tising  contrary  to  law. 

Many  names  in  the  catalogue  of  these  early  physi 
cians  have  been  associated,  in  later  periods,  with  the 
practice  of  the  profession,  —  among  them,  Boylston, 
Clark,  Danforth,  Homan,  Jeffrey,  Kittredge,  Oliver, 
Veaslee,  Randall,  Shattuck,  Thacher,  Wellington,  Wil 
liams,  Woodward.  Touton  was  a  Huguenot,  Burch- 
Bted  a  German  from  Silesia,  Lunerus  a  German  or  a 
Pole  ;  "Pighogg  Churrergeon,"  I  hope,  for  the  honor 
of  the  profession,  was  only  Peacock  disguised  undei 


818  MEDICAL  ESSAYS. 

tibis  alias,  which  would  not,  I  fear,  prove  very  attract* 
ive  to  patients. 

What  doctrines  and  practice  were  these  colonists 
likely  to  bring  with  them  ? 

Two  principal  schools  of  medical  practice  prevailed 
in  the  Old  World  during  the  greater  part  of  the  seven 
teenth  century.  The  first  held  to  the  old  methods  of 
Galen :  its  theory  was  that  the  body,  the  microcosm, 
like  the  macrocosm,  was  made  up  of  the  four  elements 
—  fire,  air,  water,  earth  ;  having  respectively  the  qual 
ities  hot,  dry,  moist,  cold.  The  body  was  to  be  pre 
served  in  health  by  keeping  each  of  these  qualities  in 
its  natural  proportion;  heat,  by  the  proper  tempera 
ture  ;  moisture,  by  the  due  amount  of  fluid ;  and  so 
as  to  the  rest.  Diseases  which  arose  from  excess  of 
heat  were  to  be  attacked  by  cooling  remedies ;  those 
from  excess  of  cold,  by  heating  ones  -,  and  so  of  the 
other  derangements  of  balance.  This  was  truly  the 
principle  of  contraria  contrariis,  which  ill-informed 
persons  have  attempted  to  make  out  to  be  the  general 
doctrine  of  medicine,  whereas  there  is  no  general  dogma 
other  than  this :  disease  is  to  be  treated  by  anything 
that  is  proved  to  cure  it.  The  means  the  Galenist 
employed  were  chiefly  diet  and  vegetable  remedies, 
with  the  use  of  the  lancet  and  other  depleting  agents. 
He  attributed  the  four  fundamental  qualities  to  differ 
ent  vegetables,  in  four  different  degrees ;  thus  chicory 
was  cold  in  the  fourth  degree,  pepper  was  hot  in  the 
fourth,  endive  was  cold  and  dry  in  the  second,  and  bit 
ter  almonds  were  hot  in  the  first  and  dry  in  the  second 
degree.  When  we  say  "  cool  as  a  cucumber,"  we  are 
talking  Galenism.  The  seeds  of  that  vegetable  ranked 
as  one  of  "  the  four  greater  cold  seeds  "  of  this  system. 


THE  MEDICAL  PROFESSION  IN  MASSACHUSETTS.   319 

Galenism  prevailed  mostly  in  the  south  of  Europe  and 
France.  The  readers  of  Moli£re  will  have  no  difficulty 
in  recalling  some  of  its  favorite  modes  of  treatment, 
and  the  abundant  mirth  he  extracted  from  them. 

These  Galenists  were  what  we  should  call  "herb-doc 
tors  "  to-day.  Their  insignificant  infusions  lost  credit 
after  a  time ;  their  absurdly  complicated  mixtures  ex 
cited  contempt,  and  their  nauseous  prescriptions  pro 
voked  loathing  and  disgust.  A  simpler  and  bolder 
practice  found  welcome  in  Germany,  depending  chiefly 
on  mineral  remedies,  mercury,  antimony,  sulphur,  ar 
senic,  and  the  use,  sometimes  the  secret  use,  of  opium. 
Whatever  we  think  of  Paracelsus,  the  chief  agent  in 
the  introduction  of  these  remedies,  and  whatever  limits 
we  may  assign  to  the  use  of  these  long-trusted  mineral 
drugs,  there  can  be  no  doubt  that  the  chemical  school, 
as  it  was  called,  did  a  great  deal  towards  the  expur 
gation  of  the  old,  overloaded,  and  repulsive  pharma 
copeia.  We  shall  find  evidence  in  the  practice  of 
our  New-England  physicians  of  the  first  century,  that 
they  often  employed  chemical  remedies,  and  that,  by 
the  early  part  of  the  following  century,  their  chief 
trust  was  hi  the  few  simple,  potent  drugs  of  Para 
celsus. 

We  have  seen  that  many  of  the  practitioners  of 
medicine,  during  the  first  century  of  New  England, 
were  clergymen.  This  relation  between  medicine  and 
theology  has  existed  from  a  very  early  period ;  from 
the  Egyptian  priest  to  the  Indian  medicine-man,  the 
alliance  has  been  maintained  in  one  form  or  another. 
The  partnership  was  very  common  among  our  British 
ancestors.  Mr.  Ward,  the  Vicar  of  Stratf ord-on-Avon, 
himself  a  notable  example  of  the  union  of  the  two  char 
acters,  writing  about  1660,  says,  — 


320  MEDICAL  ESSAYS. 

"  The  Saxons  had  their  blood-letters,  but  under  the 
Normans  physicke,  begunne  in  England;  300  years 
agoe  itt  was  not  a  distinct  profession  by  itself,  but 
practised  by  men  in  orders,  witness  Nicholas  de  Tern- 
ham,  the  chief  English  physician  and  Bishop  of  Dur 
ham  r  Hugh  of  Evesham,  a  physician  and  cardinal ; 
Grysant,  physician  and  pope  ;  John  Chambers,  Dr.  of 
Physick,  was  the  first  Bishop  of  Peterborough ;  Paul 
Bush,  a  bachelor  of  divinitie  in  Oxford,  was  a  man 
well  read  in  physick  as  well  as  divinitie,  he  was  the 
first  bishop  of  Bristol.0 

"  Again  in  King  Richard  the  Second's  time  physi 
cians  and  divines  were  not  distinct  professions  ;  for  one 
Tydeman,  Bishop  of  Landaph  and  Worcester,  was 
physician  to  King  Richard  the  Second."6 

This  alliance  may  have  had  its  share  in  creating  and 
keeping  up  the  many  superstitions  which  have  figured 
so  largely  in  the  history  of  medicine.  It  is  curious  to 
see  that  a  medical  work  left  in  manuscript  by  the  Rev. 
Cotton  Mather  and  hereafter  to  be  referred  to,  is  run 
ning  over  with  follies  and  superstitious  fancies  ;  while 
his  contemporary  and  fellow-townsman,  William  Doug 
lass,  relied  on  the  same  few  simple  remedies  which, 
through  Dr.  Edward  Holyoke  and  Dr.  James  Jackson, 
have  come  down  to  our  own  time,  as  the  most  impor 
tant  articles  of  the  materia  medica. 

Let  us  now  take  a  general  glance  at  some  of  the 
conditions  of  the  early  settlers ;  and  first,  as  to  the 
healthfulness  of  the  climate.  The  mortality  of  the 
season  that  followed  the  landing  of  the  Pilgrims  at 
Plymouth  has  been  sufficiently  accounted  for.  After 

"  Diary  of  the  Rev.  John  Ward,  A.  M.,  p.  117.    London,  183ft 
6  Ibid.  p.  160. 


THE  MEDICAL  PROFESSION  IN  MASSACHUSETTS.    321 

this,  the  colonists  seem  to  have  found  the  new  country 
agreeing  very  well  with  their  English  constitutions. 
Its  clear  air  is  the  subject  of  eulogy.  Its  dainty  springs 
of  sweet  water  are  praised  not  only  by  Higginson  and 
Wood,  but  even  the  mischievous  Morton  says,  that  for 
its  delicate  waters  Canaan  came  not  near  this  country." 
There  is  a  tendency  to  dilate  on  these  simple  blessings, 
which  reminds  one  a  little  of  the  Marchioness  in  Dick- 
ens's  story,  with  her  orange-peel-and-water  beverage. 
Still  more  does  one  feel  the  warmth  of  coloring, —  such 
as  we  expect  from  converts  to  a  new  faith,  and  settlers 
who  want  to  entice  others  over  to  their  clearings,  — 
when  Winslow  speaks,  in  1621,  of  "  abundance  of  roses, 
white,  red,  and  damask;  single,  but  very  sweet  in 
deed  ; "  a  most  of  all,  however,  when,  in  the  same  con 
nection,  he  says,  "  Here  are  grapes  white  and  red,  and 
very  sweet  and  strong  also."  This  of  our  wild  grape, 
a  little  vegetable  Indian,  which  scalps  a  civilized  man's 
mouth,  as  his  animal  representative  scalps  his  cranium. 
But  there  is  something  quite  charming  in  Winslow's 
picture  of  the  luxury  in  which  they  are  living.  Lob 
sters,  oysters,  eels,  mussels,  fish  and  fowl,  delicious 
fruit,  including  the  grapes  aforesaid,  —  if  they  only 
had  "  kine,  horses,  and  sheep,"  he  makes  no  question 
but  men  would  live  as  contented  here  as  in  any  part 
of  the  world.  We  cannot  help  admiring  the  way  in 
which  they  took  their  trials,  and  made  the  most  of  their 
blessings. 

"  And  how  Content  they  were,"  says  Cotton  Mather, 
u  when  an  Honest  Man,  as  I  have  heard,  inviting  his 
Friends  to  a  Dish  of  Clams,  at  the  Table  gave  Thanks 
to  Heaven,  who  had  given  them  to  suck  the  abur* 

•  Chronicles  of  the  Pilgrims,  p.  129,  note. 

*  Ibid.  p.  234 


822  MEDICAL  ESSAYS. 

dance  of  the  Seas,  and  of  the  Treasures  hid  in  th* 
Sands!"9 

Strangely  enough,  as  it  would  seem,  except  for  thia 
buoyant  determination  to  make  the  best  of  everything, 
they  hardly  appear  to  recognize  the  difference  of  the 
climate  from  that  which  they  had  left.  After  almost 
three  years'  experience,  Winslow  says,  he  can  scarce 
distinguish  New  England  from  Old  England,  in  respect 
of  heat  and  cold,  frost,  snow,  rain,  winds,  etc.  The 
winter,  he  thinks  (if  there  is  a  difference),  is  sharper 
and  longer  ;  but  yet  he  may  be  deceived  by  the  want 
of  the  comforts  he  enjoyed  at  home.  He  cannot  con 
ceive  any  climate  to  agree  better  with  the  constitution 
of  the  English,  not  being  oppressed  with  extremity  of 
heats,  nor  nipped  by  biting  cold  :  — 

"  By  which  means,  blessed  be  God,  we  enjoy  our 
health,  notwithstanding  those  difficulties  we  have  un 
dergone,  in  such  a  measure  as  would  have  been  ad 
mired,  if  we  had  lived  in  England  with  the  like 
means."  * 

Edward  Johnson,  after  mentioning  the  shifts  to 
which  they  were  put  for  food,  says,  — 

"  And  yet,  methinks,  our  children  are  as  cheerful, 
fat,  and  lusty,  with  feeding  upon  those  mussels,  clams, 
and  other  fish,  as  they  were  in  England  with  their  fill 
of  bread."  « 

Higginson,  himself  a  dyspeptic,  "continually  in  phy- 
sic,"  as  he  says,  and  accustomed  to  dress  in  thick  cloth 
ing,  and  to  comfort  his  stomach  with  drink  that  wag 
"both  strong  and  stale," d — the  "  jolly  good  ale  and 

*  Magnalia,  book  i.  chap.  5. 

*  Chronicles  of  the  Pilgrims,  pp.  369,  870 
0  Chron.  of  Mass.  p.  852,  note. 

*  Ibid.  pp.  251,  252. 


THE  MEDICAL   PKOFESSION  IN  MASSACHUSETTS.   323 

old,"  I  suppose,  of  free  and  easy  Bishop  Still's  song, 

—  found  that  he  both  could  and  did  oftentimes  drink 
New  England  water  very  well,  —  which  he  seems  to* 
look  upon  as  a  remarkable  feat.     He  could  go  as  light- 
clad  as  any,  too,  with  only  a  light  stuff  cassock  upon 
his  shirt,  and  stuff  breeches  without  linings.     Two  of 
his  children  were  sickly:  one, — little  misshapen  Mary, 

—  died   on  the  passage,  and,  in   her  father's  words, 
"  was  the  first  in  our  ship  that  was  buried  in  the  bow 
els  of  the  great  Atlantic  sea  ;  "  a  the  other,  who  had 
been  "  most  lamentably  handled  "  by  disease,  recovered 
almost  entirely  "  by  the  very  wholesomeness  of  the  air, 
altering,  digesting,  and  drying  up  the  cold  and  crude 
humors  of  the  body."     Wherefore,  he  thinks  it  a  wise 
course  for  all  cold  complexions  to  come  to  take  physic 
in  New  England,  and  ends  with  those  often  quoted 
words,  that  "  a  sup  of  New  England's  air  is  better  than 
a  whole  draught  of  Old  England's  ale."  *    Mr.  Hig- 
ginson  died,  however,  "  of  a  hectic  fever,"  a  little  more 
than  a  year  after  his  arrival. 

The  medical  records  which  I  shall  cite  show  that 
the  colonists  were  not  exempt  from  the  complaints  of 
the  Old  World.  Besides  the  common  diseases  to  which 
their  descendants  are  subject,  there  were  two  others,  — 
to  say  nothing  of  the  dreaded  small-pox,  which  later 
medical  science  has  disarmed,  —  little  known  among 
us  at  the  present  day,  but  frequent  among  the  first  set 
tlers.  The  first  of  these  was  the  scurvy,  already  men 
tioned,  of  which  Winthrop  speaks  in  1630,  saying, 
that  it  proved  fatal  to  those  who  fell  into  discontent, 
and  lingered  after  their  former  conditions  in  England ; 
the  poor  homesick  creatures  in  fact,  whom  we  so  forget 
in  our  florid  pictures  of  the  early  times  of  the  little 
•  Chron.  of  Mass.  p.  223.  *  Ibid  p.  252. 


824  MEDICAL  ESSATS. 

band  in  the  wilderness.  Many  who  were  suffering 
from  scurvy  got  well  when  the  Lyon  arrived  from 
England,  bringing  store  of  juice  of  lemons.0  The  Gov 
ernor  speaks  of  another  case  in  1644 ;  and  it  seems 
probable  that  the  disease  was  not  of  rare  occurrence. 

The  other  complaint  from  which  they  suffered,  but 
which  has  nearly  disappeared  from  among  us,  was  in 
termittent  fever,  or  fever  and  ague.  I  investigated  the 
question  as  to  the  prevalence  of  this  disease  in  New 
England,  in  a  dissertation,  which  was  published  in  a 
volume  with  other  papers,  in  the  year  1838.  I  can 
add  little  to  the  facts  there  recorded.  One  which  es 
caped  me  was,  that  Joshua  Scottow,  in  "  Old  Men's 
Tears,"  dated  1691,  speaks  of  "  shaking  agues,"  as 
among  the  trials  to  which  they  had  been  subjected. 
The  outline  map  of  New  England,  accompanying  the 
dissertation  above  referred  to,  indicates  all  the  places 
where  I  had  evidence  that  the  disease  had  originated. 
It  was  plain  enough  that  it  used  to  be  known  in  many 
localities  where  it  has  long  ceased  to  be  feared.  Still 
it  was  and  is  remarkable  to  see  what  a  clean  bill  of 
health  in  this  particular  respect  our  barren  soil  in 
herited  with  its  sterility.  There  are  some  malarious 
spots  on  the  edge  of  Lake  Champlain,  and  there  have 
been  some  temporary  centres  of  malaria,  within  the 
memory  of  man,  on  one  or  more  of  our  Massachusetts 
rivers,  but  these  are  harmless  enough,  for  the  most 
part,  unless  the  millers  dam  them,  when  they  are  apt 
to  retaliate  with  a  whiff  from  their  meadows,  that  sets 
the  whole  neighborhood  shaking  with  fever  and  ague. 

The  Pilgrims  of  the    Mayflower  had  with  them  a 
good  physician,  a  man  of  standing,  a  deacon  of  their 
a  Winthrop's  New  England,  >ol.  i.  pp.  44,  45. 


THE  MEDICAL  PROFESSION   IN   MASSACHUSETTS.   325 

church,  one  whom  they  loved  and  trusted,  Dr.  Samuel 
Fuller.  But  no  medical  skill  could  keep  cold  and 
hunger  and  bad  food,  and,  probably  enough,  desperate 
homesickness  in  some  of  the  feebler  sort,  from  doing 
their  work.  No  detailed  record  remains  of  what  they 
suffered  or  what  was  attempted  for  their  relief  during 
the  first  sad  whiter.  The  graves  of  those  who  died 
were  levelled  and  sowed  with  gram  that  the  losses  of 
the  little  band  might  not  be  suspected  by  the  savage 
tenants  of  the  wilderness,"  and  their  story  remains  un 
told. 

Of  Dr.  Fuller's  practice,  at  a  later  period,  we  have 
an  account  in  a  letter  of  his  to  Governor  Bradford, 
dated  June,  1630.  "  I  have  been  to  Matapan  "  (now 
Dorchester),  he  says,  "  and  let  some  twenty  of  those 
people  blood."  6  Such  wholesale  depletion  as  this,  ex 
cept  with  avowed  homicidal  intent,  is  quite  unknown 
in  these  days  ;  though  I  once  saw  the  noted  French  sur 
geon,  Lisfranc,  in  a  fine  phlebotomizing  frenzy,  order 
some  ten  or  fifteen  patients,  taken  almost  indiscrimi 
nately,  to  be  bled  in  a  single  morning. 

Dr.  Fuller's  two  visits  to  Salem,  at  the  request  of 
Governor  Endicott,  seem  to  have  been  very  satisfactory 
to  that  gentleman."  Morton,  the  wild  fellow  of  Merry 
Mount,  gives  a  rather  questionable  reason  for  the  Gov 
ernor's  being  so  well  pleased  with  the  physician's  do 
ings.  The  names  under  which  he  mentions  the  two 
personages,  it  will  be  seen,  are  not  intended  to  be  com 
plimentary.  "  Dr.  Noddy  did  a  great  cure  for  Cap 
tain  Littleworth.  He  cured  him  of  a  disease  called  a 
wife."  d  William  Gager,  who  came  out  with  Win 

•  Holmes's  Annals,  voL  L  p.  168,  note. 
»  Chron.  of  Mass.  p.  312. 

•  Ibid.  p.  32.  *  Ibid.  p.  131. 


826  MEDICAL  ESSAYS. 

throp,  is  spoken  of  as  "  a  right  godly  man  and  skilful 
chyrurgeon,"  but  died  of  a  malignant  fever  not  very 
long  after  his  arrival.* 

Two  practitioners  of  the  ancient  town  of  Newbury 
are  entitled  to  special  notice,  for  different  reasons. 
The  first  is  Dr.  John  Clark,  who  is  said  by  tradition  to 
have  been  the  first  regularly  educated  physician  who 
resided  in  New  England.  His  portrait,  in  close-fitting 
skull-cap,  with  long  locks  and  venerable  flowing  beard, 
is  familiar  to  our  eyes  on  the  wall  of  our  Society's  ante 
chamber.  His  left  hand  rests  upon  a  skull,  his  right 
hand  holds  an  instrument  which  deserves  a  passing  com 
ment.  It  is  a  trephine,  a  surgical  implement  for  cut 
ting  round  pieces  out  of  broken  skulls,  so  as  to  get  at 
the  fragments  which  have  been  driven  in,  and  lift  them 
up.  It  has  a  handle  like  that  of  a  gimlet,  with  a  claw 
.like  a  hammer,  to  lift  with,  I  suppose,  which  last  con 
trivance  I  do  not  see  figured  in  my  books.  But  the 
point  I  refer  to  is  this :  the  old  instrument,  the  trepan, 
had  a  handle  like  a  wimble,  —  what  we  call  a  brace  or 
bit-stock.  The  trephine  is  not  mentioned  at  all  in 
Peter  Lowe's  book,  London,  1634  ;  nor  in  Wiseman's 
great  work  on  Surgery,  London,  1676 ;  nor  in  the 
translation  of  Dionis,  published  by  Jacob  Tonson,  in 
1710.  In  fact  it  was  only  brought  into  more  general 
use  by  Cheselden  and  Sharpe  so  late  as  the  beginning 
of  the  last  century.6  As  John  Clark  died  in  1661,  it 
is  remarkable  to  see  the  last  fashion  in  the  way  of  skull- 
sawing  contrivances  in  his  hands,  — to  say  nothing  of 
the  claw  on  the  handle,  and  a  Key's  saw,  so  called  in 
England,  lying  on  the  table  by  him,  and  painted  there 
more  than  a  hundred  years  before  Hey  was  born.  This 

*  Winthrop's  New  England,  vol.  i.  p.  88. 

*  British  and  For.  Med.  Rev.  vol.  xvi.  p.  49, 


THE  MEDICAL  PROFESSION  IN  MASSACHUSETTS.   327 

saw  is  an  old  invention,  perhaps  as  old  as  Hippocrates, 
and  may  be  seen  figured  in  the  "  Armamentarium  Chi- 
rurgicum  "  of  Scultetus,  or  in  the  Works  of  Ambroise 
Pare*. 

Dr.  Clark  is  said  to  have  received  a  diploma  before 
he  came,  for  skill  in  lithotomy."  He  loved  horses,  as  a 
good  many  doctors  do,  and  left  a  good  property,  as  they 
all  ought  to  do.  His  grave  and  noble  presence,  with 
the  few  facts  concerning  him,  told  with  more  or  less 
traditional  authority,  give  us  the  feeling  that  the  peo 
ple  of  Newbury,  and  afterwards  of  Boston,  had  a  wise 
and  skilful  medical  adviser  and  surgeon  in  Dr.  John 
Clark. 

The  venerable  town  of  Newbury  had  another  phy 
sician  who  was  less  fortunate.  The  following  is  a  court 
record  of  1652  :  — 

"  This  is  to  certify  whom  it  may  concern,  that  we 
the  subscribers,  being  called  upon  to  testify  against 
[doctor]  "William  Snelling  for  words  by  him  uttered, 
affirm  that  being  in  way  of  merry  discourse,  a  health 
being  drank  to  all  friends,  he  answered,  — 

*  I  '11  pledge  my  friends, 
And  for  my  foes 
A  plague  for  their  heels 
And,'  — 

[a  similar  malediction  on  the  other  extremity  of  their 
feet.] 

"  Since  when  he  hath  affirmed  that  he  only  intended 
the  proverb  used  in  the  west  country,  nor  do  we  believe 
he  intended  otherwise. 

[Signed]  WILLIAM  THOMAS. 

THOMAS  MILWARD. 

"March  12th  1651,  All  which  I  acknowledge,  and  1 
"  Thacher,  Med.  Biography,  p.  222. 


328  MEDICAL  ESSAYS. 

am  sorry  I  did  not  expresse  my  intent,  or  that  I  was 
BO  weak  as  to  use  so  foolish  a  proverb. 

[Signed]  GULIELMUS  SNELLING." 

Notwithstanding  this  confession  and  apology,  the 
record  tells  us  that  "  William  Snelling  in  his  present 
ment  for  cursing  is  fined  ten  shillings  and  the  fees  of 
court."" 

I  will  mention  one  other  name  among  those  of  the 
Fathers  of  the  medical  profession  in  New  England. 
The  "apostle"  Eliot  says,  writing  in  1647,  "We 
never  had  but  one  anatomy  in  the  country,  which  Mr. 
Giles  Firman,  now  in  England,  did  make  and  read 
upon  very  well."  * 

Giles  Firmin,  as  the  name  is  commonly  spelled, 
practised  physic  in  this  country  for  a  time.  He  seems 
to  have  found  it  a  poor  business ;  for,  in  a  letter  to 
Governor  Winthrop,  he  says,  "  I  am  strongly  sett  upon 
to  studye  divinitie :  my  studyes  else  must  be  lost,  for 
physick  is  but  a  meene  helpe."  e 

Giles  Firmin's  Lectures  on  Anatomy  were  the  first 
scientific  teachings  of  the  New  World.  While  the 
Fathers  were  enlightened  enough  to  permit  such  in 
structions,  they  were  severe  in  dealing  with  quackery; 
for,  in  1631,  our  court  records  show  that  one  Nich 
olas  Knopp,  or  Knapp,  was  sentenced  to  be  fined  or 
whipped  "  for  taking  upon  him  to  cure  the  scurvey  by 
a  water  of  noe  worth  nor  value,  which  he  solde  att  a  very 
deare  rate."  d  Empty  purses  or  sore  backs  would  be 
common  with  us  to-day  if  such  a  rule  were  enforced. 

Besides  the  few  worthies  spoken  of,  and  others  whose 

"  Coffin,  Hist,  of  Newbury,  p.  55. 

•  Hist.  Coll.  3d  Series,  vol.  iv.  p.  57. 

•  Winthrop  Papers  in  Hist.  Coll.  4th  Series,  voL  vii.  p.  278. 

•  Mass.  Col.  Court  Records,  vol.  i.  p.  63. 


THE  MEDICAL  PROFESSION   IN  MASSACHUSETTS.    329 

names  I  have  not  space  to  record,  we  must  remember 
that  there  were  many  clergymen  who  took  charge 
of  the  bodies  as  well  as  the  souls  of  their  patients, 
among  them  two  Presidents  of  Harvard  College, — 
Charles  Chauncy  and  Leonard  Hoar,  —  and  Thomas 
Thacher,  first  minister  of  the  "  Old  South,"  author  of 
the  earliest  medical  treatises  printed  in  the  country,* 
whose  epitaph  in  Latin  and  Greek,  said  to  have  been 
written  by  Eleazer,  an  "  Indian  Youth  "  and  a  mem 
ber  of  the  Senior  Class  of  Harvard  College,  may  be 
found  in  the  "Magnalia."  6  I  miss  this  noble  savage's 
name  in  our  triennial  catalogue ;  and  as  there  is  many 
a  slip  between  the  cup  and  lip,  one  is  tempted  to  guess 
that  he  may  have  lost  his  degree  by  some  display  of 
his  native  instinct,  —  possibly  a  flourish  of  the  tom 
ahawk  or  scalping-knife.  However  this  may  have 
been,  the  good  man  he  celebrated  was  a  notable  in 
stance  of  the  Angelical  Conjunction,  as  the  author  of 
the  "  Magnalia  "  calls  it,  of  the  offices  of  clergyman 
and  medical  practitioner. 

Michael  Wigglesworth,  author  of  the  "  Day  of 
Doom,"  attended  the  sick,  "  not  only  as  a  Pastor,  but 
as  a  Physician  too,  and  this,  not  only  in  his  own  town, 
but  also  in  all  those  of  the  vicinity."*  Mather  says 
of  the  sons  of  Charles  Chauncy,  "All  of  these  did, 
while  they  had  Opportunity,  Preach  the  Gospel ;  and 
most,  if  not  all  of  them,  like  their  excellent  Father  be 
fore  them,  had  an  eminent  skill  in  physick  added  unto 
their  other  accomplishments,"  etc.  Roger  Williams  is 

*  A  Brief  Rule  to  Guide  the  Common  People  in  Small-pox  and 
Measles.     1674. 

*  Book  iii.  chap.  26. 

*  Cotton  Mather's  Funeral  Sermon,  preached  January  24, 
1705. 


830  MEDICAL  ESSAYS. 

said  to  have  saved  many  in  a  kind  of  pestilence  which 
swept  away  many  Indians. 

To  these  names  must  be  added,  as  sustaining  a  cer 
tain  relation  to  the  healing  art,  that  of  the  first  Gov 
ernor  Winthrop,  who  is  said  by  John  Cotton  to  have 
been  "  Help  for  our  Bodies  by  Physick  [and]  for  our 
Estates  by  Law,"  a  and  that  of  his  son,  the  Governor 
of  Connecticut,  who,  as  we  shall  see,  was  as  much  phy 
sician  as  magistrate. 

I  had  submitted  to  me  for  examination,  in  1862,  a 
manuscript  found  among  the  Winthrop  Papers,  marked 
with  the  superscription,  "  For  my  worthy  friend  Mr. 
Wintrop,"  dated  in  1643,  London,  signed  Edward 
Stafford,  and  containing  medical  directions  and  pre 
scriptions.  It  may  be  remembered  by  some  present 
that  I  wrote  a  report  on  this  paper,  which  was  pub 
lished  in  the  "  Proceedings  "  of  this  Society.  Whether 
the  paper  was  written  for  Governor  John  Winthrop 
of  Massachusetts,  or  for  his  son,  Governor  John  of 
Connecticut,  there  is  no  positive  evidence  that  I  have 
been  able  to  obtain.  It  is  very  interesting,  however, 
as  giving  short  and  simple  practical  directions,  such  as 
would  be  most  like  to  be  wanted  and  most  useful,  in 
the  opinion  of  a  physician  in  repute  of  that  day. 

The  diseases  prescribed  for  are  plague,  small-pox, 
fevers,  king' s  evil,  insanity,  falling-sickness,  and  the 
like  ;  with  such  injuries  as  broken  bones,  dislocations, 
and  burning  with  gunpowder.  The  remedies  are  of 
three  kinds :  simples,  such  as  St.  John's  wort,  Clown's 
all-heal,  elder,  parsley,  maidenhair;  mineral  drugs, 
such  as  lime,  saltpetre,  Armenian  bole,  crocus  metal- 
lorum,  or  sulphuret  of  antimony;  and  thaumaturgio 
or  mystical,  of  which  the  chief  is,  "  My  black  powder 
•  Magnolia,  book  ii.  chap.  4. 


THE  MEDICAL  PROFESSION  IN  MASSACHUSETTS.   331 

against  the  plague,  small-pox ;  purples,  all  sorts  of  f  ea- 
vers ;  Poyson ;  either,  by  Way  of  Prevention  or  after 
Infection."  This  marvellous  remedy  was  made  by 
putting  live  toads  into  an  earthen  pot  so  as  to  half  fill 
it,  and  baking  and  burning  them  "  in  the  open  ayre, 
not  in  an  house," — concerning  which  latter  possibility 
I  suspect  Madam  Winthrop  would  have  had  something 
to  say,  —  until  they  could  be  reduced  by  pounding, 
first  into  a  brown,  and  then  into  a  black,  powder. 
Blood-letting  in  some  inflammations,  fasting  in  the 
early  stage  of  fevers,  and  some  of  those  peremptory 
drugs  with  which  most  of  us  have  been  well  acquainted 
in  our  time,  the  infragrant  memories  of  which  I  will 
not  pursue  beyond  this  slight  allusion,  are  among  hia 
remedies. 

The  Winthrops,  to  one  of  whom  Dr.  Stafford's  di 
rections  were  addressed,  were  the  medical  as  well  as 
the  political  advisers  of  their  fellow-citizens  for  three 
or  four  successive  generations.  One  of  them,  Gov 
ernor  John  of  Connecticut,  practised  so  extensively, 
that,  but  for  his  more  distinguished  title  in  the  State, 
he  would  have  been  remembered  as  the  Doctor.  The 
fact  that  he  practised  in  another  colony,  for  the  most 
part,  makes  little  difference  in  the  value  of  the  rec 
ords  we  have  of  his  medical  experience,  which  have 
fortunately  been  preserved,  and  give  a  very  fair  idea, 
in  all  probability,  of  the  way  in  which  patients  were 
treated  in  Massachusetts,  when  they  fell  into  intelli 
gent  and  somewhat  educated  hands,  a  little  after  the 
middle  of  the  seventeenth  century. 

I  have  before  me,  while  writing,  a  manuscript  col 
lection  of  the  medical  cases  treated  by  him,  and  re 
corded  at  the  time  in  his  own  hand,  which  has  been 
intrusted  to  me  by  our  President,  his  descendant 


532  MEDICAL  ESSAYS. 

They  are  generally  marked  Hartford,  and  extend  from 
the  year  1657  to  1669.  From  these  manuscripts,  and 
from  the  letters  printed  in  the  Winthrop  Papers  pub 
lished  by  our  Society,  I  have  endeavored  to  obtain 
some  idea  of  the  practice  of  Governor  John  Winthrop, 
Junior.  The  learned  eye  of  Mr.  Pulsifer  would  have 
helped  me,  no  doubt,  as  it  has  done  in  other  cases  ;  but 
I  have  ventured  this  time  to  attempt  finding  my  own 
way  among  the  hieroglyphics  of  these  old  pages.  By 
careful  comparison  of  many  prescriptions,  and  by  the 
aid  of  Schroder,  Salmon,  Culpeper,  and  other  old 
compilers,  I  have  deciphered  many  of  his  difficult  par 
agraphs  with  their  mysterious  recipes. 

The  Governor  employed  a  number  of  the  simples 
dear  to  ancient  women,  —  elecampane  and  elder  and 
wormwood  and  anise  and  the  rest;  but  he  also  em- 
ployed  certain  mineral  remedies,  which  he  almost  al 
ways  indicates  by  their  ancient  symbols,  or  by  a  name 
which  should  leave  them  a  mystery  to  the  vulgar.  I 
am  now  prepared  to  reveal  the  mystic  secrets  of  the 
Governor's  beneficent  art,  which  rendered  so  many  good 
and  great  as  well  as  so  many  poor  and  dependent  peo 
ple  his  debtors, — at  least,  in  their  simple  belief, — for 
their  health  and  their  lives. 

His  great  remedy,  which  he  gave  oftener  than  any 
other,  was  nitre;  which  he  ordered  in  doses  of  twenty 
or  thirty  grains  to  adults,  and  of  three  grains  to  in- 
fants.  Measles,  colics,  sciatica,  headache,  giddiness, 
and  many  other  ailments,  all  found  themselves  treated, 
and  I  trust  bettered,  by  nitre ;  a  pretty  safe  medicine 
in  moderate  doses,  and  one  not  likely  to  keep  the  good 
Governor  awake  at  night,  thinking  whether  it  might 
not  kill,  if  it  did  not  cure.  We  may  say  as  much  for 
spermaceti,  which  he  seems  to  have  considered  "  the 


THE  MEDICAL  PROFESSION  IN  MASSACHUSETTS.   333 

sovereign'st  thing  on  earth  "  for  inward  bruises,  and 
often  prescribes  after  falls  and  similar  injuries. 

One  of  the  next  remedies,  in  point  of  frequency, 
which  he  was  in  the  habit  of  giving,  was  (probably 
diaphoretic)  antimony ;  a  mild  form  of  that  very  ac 
tive  metal,  and  which,  mild  as  it  was,  left  his  patients 
very  commonly  with  a  pretty  strong  conviction  that 
they  had  been  taking  something  that  did  not  exactly 
agree  with  them.  Now  and  then  he  gave  a  little  iron 
or  sulphur  or  calomel,  but  very  rarely ;  occasionally,  a 
good,  honest  dose  of  rhubarb  or  jalap ;  a  taste  of  sting 
ing  horseradish,  of tener  of  warming  guiacum ;  some 
times  an  anodyne,  in  the  shape  of  mithridate,  —  the 
famous  old  farrago,  which  owed  its  virtue  to  poppy 
juice ; a  very  often,  a  harmless  powder  of  coral ;  less 
frequently,  an  inert  prescription  of  pleasing  amber ; 
and  (let  me  say  it  softly  within  possible  hearing  of 
his  honored  descendant),  twice  or  of  tener,  —  let  us 
hope  as  a  last  resort,  —  an  electuary  of  millipedes, 
—  sowbugs,  if  we  must  give  them  their  homely  Eng 
lish  name.  One  or  two  other  prescriptions,  of  the 
many  unmentionable  ones  which  disgraced  the  phar 
macopoeia  of  the  seventeenth  century,  are  to  be  found, 
but  only  in  very  rare  instances,  in  the  faded  characters 
of  the  manuscript. 

The  excellent  Governor's  accounts  of  diseases  are  so 
brief,  that  we  get  only  a  very  general  notion  of  the 
complaints  for  which  he  prescribed.  Measles  and 
their  consequences  are  at  first  more  prominent  than 
any  other  one  affection,  but  the  common  infirmities  of 

•  This  is  the  remedy  which  a  Boston  divine  tried  to  simplify. 
See  Electuarium  Novum  Alexipharmacum,  by  Rev.  Thomas  Har 
vard,  lecturer  at  the  Royal  Chappell.  Boston,  1732.  This  tract 
is  in  our  Society's  library. 


834  MEDICAL  ESSAYS. 

both  sexes  and  of  all  ages  seem  to  have  come  undei 
his  healing  hand.  Fever  and  ague  appears  to  have 
been  of  frequent  occurrence. 

His  published  correspondence  shows  that  many 
noted  people  were  in  communication  with  him  as  his 
patients.  Roger  Williams  wants  a  little  of  his  medi 
cine  for  Mrs.  Weekes's  daughter ;  worshipful  John 
Haynes  is  in  receipt  of  his  powders  ;  troublesome  Cap 
tain  Underbill  wants  "  a  little  white  vitterall  "  for  his 
wife,  and  something  to  cure  his  wife's  friend's  neural 
gia  (I  think  his  wife's  friend's  husband  had  a  little 
rather  have  had  it  sent  by  the  hands  of  Mrs.  Under 
bill,  than  by  those  of  the  gallant  and  discursive  cap- 
tarn)  ;  and  pious  John  Davenport  says,  his  wife  "  tooke 
but  one  halfe  of  one  of  the  papers "  (which  probably 
contained  the  medicine  he  called  rubila),  "  but  could 
not  beare  the  taste  of  it,  and  is  discouraged  from  tak 
ing  any  more ; "  and  honored  William  Leete  asks  for 
more  powders  for  his  "  poore  little  daughter  "  Graci- 
ana,  though  he  found  it  "  hard  to  make  her  take  it," 
delicate,  and  of  course  sensitive,  child  as  she  was,  lan 
guishing  and  dying  before  her  time,  in  spite  of  all  the 
bitter  things  she  swallowed,  —  God  help  all  little  chil 
dren  in  the  hands  of  dosing  doctors  and  howling  der 
vishes  I  Restless  Samuel  Gorton,  now  tamed  by  the 
burden  of  fourscore  and  two  years,  writes  so  touching 
an  account  of  his  infirmities,  and  expresses  such  over 
flowing  gratitude  for  the  relief  he  has  obtained  from 
the  Governor's  prescriptions,  wondering  how  "  a  thing 
so  little  in  quantity,  so  little  in  sent,  so  little  in  taste, 
and  so  little  to  sence  in  operation,  should  beget  and 
bring  forth  such  efects,"  that  we  repent  our  hasty  ex 
clamation,  and  bless  the  memory  of  the  good  Gov 
ernor,  who  gave  relief  to  the  worn-out  frame  of  our 


THE  MEDICAL  PROFESSION  IN  MASSACHUSETTS.   335 

long-departed  brother,  the  sturdy  old  heretic  of  Rhode 
Island. 

What  was  that  medicine  which  so  frequently  occurs 
in  the  printed  letters  under  the  name  of  "  rubila  "  ? 
It  is  evidently  a  secret  remedy,  and,  so  far  as  I  know, 
has  not  yet  been  made  out.  I  had  almost  given  it  up 
in  despair,  when  I  found  what  appears  to  be  a  key  to 
the  mystery.  In  the  vast  multitude  of  prescriptions 
contained  in  the  manuscripts,  most  of  them  written  in 
symbols,  I  find  one  which  I  thus  interpret :  — 

"  Four  grains  of  (diaphoretic)  antimony,  with  twenty 
grains  of  nitre,  with  a  little  salt  of  tin,  making  ru 
bila"  Perhaps  something  was  added  to  redden  the 
powder,  as  he  constantly  speaks  of  "  rubifying "  or 
"  viridating  "  his  prescriptions ;  a  very  common  prac 
tice  of  prescribers,  when  their  powders  look  a  little  too 
much  like  plain  salt  or  sugar. 

"Waitstill  Winthrop,  the  Governor's  son,  "was  a 
skilful  physician,"  says  Mr.  Sewall,  in  his  funeral  ser 
mon  ;  "  and  generously  gave,  not  only  his  advice,  but 
also  his  Medicines,  for  the  healing  of  the  Sick,  which, 
by  the  Blessing  of  God,  were  made  successful  for  the 
recovery  of  many."  a  If  is  son  John,  a  member  of  the 
Royal  Society,  speaks  of  himself  as  "  Dr.  Winthrop," 
and  mentions  one  of  his  own  prescriptions  in  a  letter 
to  Cotton  Mather.  Our  President  tells  me  that  there 
was  an  heirloom  of  the  ancient  skill  in  his  family, 
within  his  own  remembrance,  in  the  form  of  a  certain 
pracious  eye-water,  to  which  the  late  President  John 
Quincy  Adams  ascribed  rare  virtue,  and  which  he 
used  to  obtain  from  the  possessor  of  the  ancient  recipe. 

•  See  also  his  epitaph  in  Life  and  Letters  of  John  Winthrop 
by  his  descendant^  Hon.  Robert  C.  Wiathrop. 


336  MEDICAL   ESSAYS. 

These  inherited  prescriptions  are  often  treasured  in 
families,  I  do  not  doubt,  for  many  generations.  When 
I  was  yet  of  trivial  age,  and  suffering  occasionally,  as 
many  children  do,  from  what  one  of  my  Cambridge- 
port  schoolmates  used  to  call  the  "  ager,"  —  meaning 
thereby  toothache  or  f aceache,  —  I  used  to  get  relief 
from  a  certain  plaster  which  never  went  by  any  other 
name  in  the  family  than  "  Dr.  Oliver." 

Dr.  James  Oliver  was  my  great-great-grandfather, 
graduated  in  1680,  and  died  in  1703.  This  was,  no 
doubt,  one  of  his  nostrums  ;  for  nostrum,  as  is  well 
known,  means  nothing  more  than  our  own  or  my  own 
particular  medicine,  or  other  possession  or  secret,  and 
physicians  in  old  times  used  to  keep  their  choice 
recipes  to  themselves  a  good  deal,  as  we  have  had  oc 
casion  to  see. 

Some  years  ago  I  found  among  my  old  books  a 
small  manuscript  marked  "  James  Oliver.  This  Book 
Begun  Aug.  12,  (16)85."  It  is  a  rough  sort  of  ac 
count-book,  containing  among  other  things  prescrip 
tions  for  patients,  and  charges  for  the  same,  with 
counter-charges  for  the  purchase  of  medicines  and  other 
matters.  Dr.  Oliver  practised  in  Cambridge,  where 
may  be  seen  his  tomb  with  inscriptions,  and  with  sculp 
tured  figures  that  look  more  like  Diana  of  the  Ephe- 
sians,  as  given  in  Calmet's  Dictionary,  than  like  any 
angels  admitted  into  good  society  here  or  elsewhere. 

I  do  not  find  any  particular  record  of  what  his  pa 
tients  suffered  from,  but  I  have  carefully  copied  out 
the  remedies  he  mentions,  and  find  that  they  form  a 
very  respectable  catalogue.  Besides  the  usual  sim 
ples,  elder,  parsley,  fennel,  saffron,  snake-root,  worm 
wood,  I  find  the  Elixir  Proprietatis,  with  other  elixir* 
and  cordials,  as  if  he  rather  fancied  warming  medi 


THE  MEDICAL  PROFESSION   IN   MASSACHUSETTS.    337 

cines ;  but  he  called  in  the  aid  of  some  of  the  more 
energetic  remedies,  including  iron,  and  probably  mer 
cury,  as  he  bought  two  pounds  of  it  at  one  time. 

The  most  interesting  item  is  his  bill  against  the  es 
tate  of  Samuel  Pason  of  Roxbury,  for  services  during 
his  last  illness.  He  attended  this  gentleman,  —  for 
such  he  must  have  been,  by  the  amount  of  physic 
which  he  took,  and  which  his  heirs  paid  for,  —  from 
June  4th,  1696,  to  September  3d  of  the  same  year,  — 
three  months.  I  observe  he  charges  for  visits  as  well 
as  for  medicines,  which  is  not  the  case  in  most  of  his 
bills.  He  opens  the  attack  with  a  carminative  appeal 
to  the  visceral  conscience,  and  follows  it  up  with  good 
hard-hitting  remedies  for  dropsy,  —  as  I  suppose  the 
disease  would  have  been  called,  —  and  finishes  off  with 
a  rallying  dose  of  hartshorn  and  iron. 

It  is  a  source  of  honest  pride  to  his  descendant  that 
his  bill,  which  was  honestly  paid,  as  it  seems  to  have 
been  honorably  earned,  amounted  to  the  handsome 
total  of  seven  pounds  and  two  shillings.  Let  me  add 
that  he  repeatedly  prescribes  plaster,  one  of  which  was 
very  probably  the  "  Dr.  Oliver  "  that  soothed  my  in 
fant  griefs,  and  for  which  I  blush  to  say  that  my  ven 
erated  ancestor  received  from  Goodman  Hancock  the 
painfully  exiguous  sum  of  no  pounds,  no  shillings,  and 
sixpence. 

I  have  illustrated  the  practice  of  the  first  century, 
from  the  two  manuscripts  I  have  examined,  as  giving 
an  impartial  idea  of  its  every-day  methods.  The  Gov 
ernor,  Johannes  Secundus,  it  is  fair  to  remember,  was 
an  amateur  practitioner,  while  my  ancestor  was  a  pro» 
fessed  physician.  Comparing  their  modes  of  treat 
ment  with  the  many  scientific  follies  still  prevailing  in 
the  Old  World,  and  still  more  with  the  extraordinary 


338  MEDICAL  ESSAYS. 

theological  superstitions  of  the  community  in  whicli 
they  lived,  we  shall  find  reason,  I  think,  to  consider  the 
art  of  healing  as  in  a  comparatively  creditable  state 
during  the  first  century  of  New  England. 

In  addition  to  the  evidence  as  to  methods  of  treat 
ment  furnished  by  the  manuscripts  I  have  cited,  I  sub 
join  the  following  document,  to  which  my  attention 
was  called  by  Dr.  Shurtleff,  our  present  Mayor.  This 
is  a  letter  of  which  the  original  is  to  be  found  in  vol. 
Ixix.  page  10  of  the  "Archives"  preserved  at  the 
State  House  in  Boston.  It  will  be  seen  that  what  the 
surgeon  wanted  consisted  chiefly  of  opiates,  stimulants, 
cathartics,  plasters,  and  materials  for  bandages.  The 
complex  and  varied  formulae  have  given  place  to  sim 
pler  and  often  more  effective  forms  of  the  same  reme 
dies  ;  but  the  list  and  the  manner  in  which  it  is  made 
out  are  proofs  of  the  good  sense  and  schooling  of  the 
surgeon,  who,  it  may  be  noted,  was  in  such  haste  that 
he  neglected  all  his  stops.  He  might  well  be  in  a 
hurry,  as  on  the  very  day  upon  which  he  wrote,  a  great 
body  of  Indians  —  supposed  to  be  six  or  seven  hun 
dred  —  appeared  before  Hatfield ;  and  twenty-five  res 
olute  young  men  of  Hadley,  from  which  town  he  wrote, 
crossed  the  river  and  drove  them  away.* 

HADLY  May  30:  76 
Mr  RAWSON  S* 

What  we  have  recd  by  Tho :  Houey  the 
past  month  is  not  the  cheifest  of  our  wants  as  you 
have  love  for  poor  wounded  I  pray  let  us  not  want  for 
these  following  medicines  if  you  have  not  a  speedy 
conveyance  of  them  I  pray  send  on  purpose  they  are 
those  things  mentioned  in  my  former  letter  but  to  pre- 
rent  future  mistakes  I  have  wrote  them  att  large  wee 
•  Holmes's  Annals,  vol.  i.  p.  881. 


THE  MEDICAL  PROFESSION   IN  MASSACHUSETTS.   339 


have  great  want  with  the  greatest  hast  and  speed  let 
us  be  supplyed.  Sr 

Yr  Ser4 
WILL  LOCKE 


Imp.  Ung*  Basilic  .  .  ft  ij 
Liniment  Arcei  .  .  .  ft  ij 
Ung»  Nervin:  ....  ft  ij 
Ol:  Rosarum  .  .  .  .  B>  ij 
Ol:  terebinth:  ....  ft  ij 

Mithridat: ft  j 

Diascordii ft  j 

theriac:  Androinac:  .     .     ft  88 

Licortite ft  j 

ft  iiij 
ft  iij 
ft  iij 
ft  ij 
ft  j 
ft  j 


Emp:  Diachyl:  Cum  Gum  ft  j 


De  betonica 
Flor:  chamemseli  . 
Flor:  meliloti  .. 
Sal:  prunellas  .. 
pul:  Aloes 
«  Sem:  Anisi  Santonicse  an  5  iiij 


ft  j 

ft  j 

ft  j 

§  iiij 


Aq:  theriacalis 
Spt:  Cinnamomi  .  . 
Syr:  Gariophyllor:  . 
Syr:  Rosarum  Solut: 
Croci .  . 


ft  i] 
ft  j 
ft  ij 
ft  ij 
3  as 


Old  linnin  as  much  as  yon 
can  get 


WlLLlLOCKB 


Hord:  Gallic:  .    . 

Empl:  Diapal: 

Empl:  De  Mino   . 

Empl:  De  Meliloti 

Empl:  paracclsi  . 

Oxycroceum    .    . 

[Direction]  for  Mr  Edward  Rawson 
Seci*  :  w"1  hast  &  speed  humbly 
present  These  in 

Boston 
[Endorsed] 

Mr.  Locke's  Letter  Rec*  from  the  Governor  13  June  &  acquainted 
y"  Council  with  it  but  could  not  obtaine  any  thing  to  be  sent  in  an 
swer  thereto  13  June  1676 

I  have  given  some  idea  of  the  chief  remedies  used 
by  our  earlier  physicians,  which  were  both  Galenic  and 
chemical ;  that  is,  vegetable  and  mineral.  They,  of 
course,  employed  the  usual  perturbing  medicines  which 
Montaigne  says  are  the  chief  reliance  of  their  craft. 
There  were,  doubtless,  individual  practitioners  who  em 
ployed  special  remedies  with  exceptional  boldness  and 
perhaps  success.  Mr.  Eliot  is  spoken  of,  in  a  letter 
of  William  Leete  to  Winthrop,  Junior,  as  being  unclei 

•  Crossed  out  in  the  letter. 

*  "  The  last  was  broken." 


340  MEDICAL  ESSAYS. 

Mr.  Greenland's  mercurial  administrations."  The  lat 
ter  was  probably  enough  one  of  these  specialists. 

There  is  another  class  of  remedies  which  appears  to 
have  been  employed  occasionally,  but,  on  the  whole,  is 
so  little  prominent  as  to  imply  a  good  deal  of  common 
sense  among  the  medical  practitioners,  as  compared 
with  the  superstitions  prevailing  around  them.  I  have 
said  that  I  have  caught  the  good  Governor,  now  and 
then,  prescribing  the  electuary  of  millipedes  ;  but  he  is 
entirely  excused  by  the  almost  incredible  fact  that  they 
were  retained  in  the  materia  medica  so  late  as  when 
Rees's  Cyclopaedia  was  published,  and  we  there  find 
the  directions  formerly  given  by  the  College  of  Edin 
burgh  for  their  preparation.  Once  or  twice  we  have 
found  him  admitting  still  more  objectionable  articles 
into  his  materia  medica ;  in  doing  which,  I  am  sorry 
to  say  that  he  could  plead  grave  and  learned  authority. 
But  these  instances  are  very  rare  exceptions  in  a  medi 
cal  practice  of  many  years,  which  is,  on  the  whole,  very 
respectable,  considering  the  time  and  circumstances. 

Some  remedies  of  questionable  though  not  odious 
character  appear  occasionally  to  have  been  employed 
by  the  early  practitioners,  but  they  were  such  as  still 
had  the  support  of  the  medical  profession.  Governor 
John  Winthrop,  the  first,  sends  for  East-Indian  bezoar, 
with  other  commodities  he  is  writing  for.6  Governor 
Sndicott  sends  him  one  he  had  of  Mr.  Humfrey/  I 
hope  it  was  genuine,  for  they  cheated  infamously  in  the 
matter  of  this  concretion,  which  ought  to  come  out  of 
an  animal's  stomach,  but  the  real  history  of  which  re 
sembles  what  is  sometimes  told  of  modern  sausages, 

•  Hist.  Coll.  4th  Series,  vol.  vii.p.  575. 

•  Hist,  of  N.  England,  vol.  ii.  p.  385.     Appendix. 

•  Hist.  Coll.  4th  Series,  vol.  vii.  p.  156. 


THE  MEDICAL  PBOFESSION  IN   MASSACHUSETTS.   341 

There  is  a  famous  law-case  of  James  the  First's  time, 
in  which  a  goldsmith  sold  a  hundred  pounds'  worth  of 
what  he  called  bezoar,  which  was  proved  to  be  false, 
and  the  purchaser  got  a  verdict  against  him.  Gov 
ernor  Endicott  also  sends  Winthrop  a  unicorn's  horn, 
which  was  the  property  of  a  certain  Mrs.  Beggarly, 
who,  in  spite  of  her  name,  seems  to  have  been  rich  in 
medical  knowledge  and  possessions.0  The  famous 
Thomas  Bartholinus  wrote  a  treatise  on  the  virtues  of 
this  fabulous-sounding  remedy,  which  was  published  in 
1641,  and  republished  in  1678. 

The  "  antimonial  cup,"  a  drinking  vessel  made  of 
that  metal,  which,  like  our  quassia-wood  cups,  might 
be  filled  and  emptied  in  scecula  sceculorum  without  ex 
hausting  its  virtues,  is  mentioned  by  Matthew  Cradock, 
in  a  letter  to  the  elder  Winthrop,  but  in  a  doubtful 
way,  as  it  was  thought,  he  says,  to  have  shortened  the 
days  of  Sir  Nathaniel  Riche ;  and  Winthrop  himself,  as 
I  think,  refers  to  its  use,  calling  it  simply  "  the  cup."  6 
An  antimonial  cup  is  included  in  the  inventory  of  Sam 
uel  Seabury,  who  died  1680,  and  is  valued  at  five  shil 
lings.6  There  is  a  treatise  entitled  "  The  Universal! 
Remedy,  or  the  Vertues  of  the  Antimoniall  Cup,  By 
John  Evans,  Minister  and  Preacher  of  God's  Word, 
London,  1634,"  in  our  own  Society's  library. 

One  other  special  remedy  deserves  notice,  because 
of  native  growth.  I  do  not  know  when  Culver's  root, 
Leptandra  Virginica  of  our  National  Pharmacopeia, 
became  noted,  but  Cotton  Mather,  writing  in  1716  to 
John  Winthrop  of  New  London,  speaks  of  it  as  famous 
for  the  cure  of  consumptions,  and  wishes  to  get  some 

•  Hist.  Coll.  4th  Series,  vol.  vii.  p.  156. 
»  Hist.  ofN.  England,  vol.  i.  p.  394. 

•  Tkacher's  Medical  Biography,  p.  18. 


842  MEDICAL  ESSAYS. 

of  it,  through  his  mediation,  for  Katharine,  his  eldest 
daughter.*  He  gets  it,  and  gives  it  to  the  "  poor  dam 
sel,"  who  is  languishing,  as  he  says,  and  who  dies  the 
next  month,*  —  all  the  sooner,  I  have  little  doubt,  for 
this  uncertain  and  violent  drug,  with  which  the  meddle 
some  pedant  tormented  her  in  that  spirit  of  well-meant 
but  restless  quackery,  which  could  touch  nothing  with 
out  making  mischief,  not  even  a  quotation,  and  yet 
proved  at  length  the  means  of  bringing  a  great  blessing 
to  our  community,  as  we  shall  see  by  and  by ;  so  does 
Providence  use  our  very  vanities  and  infirmities  for 
its  wise  purposes. 

Externally,  I  find  the  practitioners  on  whom  I  have 
chiefly  relied  used  the  plasters  of  Paracelsus,  of  melilot, 
diachylon,  and  probably  diaphcenicon,  all  well  known 
to  the  old  pharmacopeias,  and  some  of  them  to  the 
modern  ones,  —  to  say  nothing  of  "  my  yellow  salve," 
of  Governor  John,  the  second,  for  the  composition  of 
which  we  must  apply  to  his  respected  descendant. 

The  authors  I  find  quoted  are  Barbette's  Surgery, 
Camerarius  on  Gout,  and  Wecherus,  of  all  whom  notices 
may  be  found  in  the  pages  of  Haller  and  Vanderlin- 
den ;  also,  Reed's  Surgery,  and  Nicholas  Culpeper's 
Practice  of  Physic  and  Anatomy,  the  last  as  belonging 
to  Samuel  Seabury,  chirurgeon,  before  mentioned. 
Nicholas  Culpeper  was  a  shrewd  charlatan,  and  as  im 
pudent  a  varlet  as  ever  prescribed  for  a  colic ;  but 
knew  very  well  what  he  was  about,  and  badgers  the 
College  with  great  vigor.  A  copy  of  Spigelius's 
famous  Anatomy,  in  the  Boston  Athenseum,  has  the 
names  of  Increase  and  Samuel  Mather  written  in  it, 
and  was  doubtless  early  overhauled  by  the  youthful 

•  Mather  Papers  in  Hist.  Coll.  4th  Series,  vol.  viii.  p.  420. 

*  Ibid.,  note. 


THE  MEDICAL  PROFESSION  IN  MASSACHUSETTS.    343 

Cotton,  who  refers  to  the  great  anatomist's  singular 
death,  among  his  curious  stories  in  the  "Magnalia," 
and  quotes  him  among  nearly  a  hundred  authors  whom 
he  cites  in  his  manuscript  "  The  Angel  of  Bethesda." 
Dr.  John  Clark's  "  books  and  instruments,  with  several 
chirurgery  materials  in  the  closet,"  a  were  valued  in  his 
inventory  at  sixty  pounds ;  Dr.  Matthew  Fuller,  who 
died  in  1678,  left  a  library  valued  at  ten  pounds ;  and 
a  surgeon's  chest  and  drugs  valued  at  sixteen  pounds.* 

Here  we  leave  the  first  century  and  all  attempts  at 
any  further  detailed  accounts  of  medicine  and  its  practi 
tioners.  It  is  necessary  to  show  in  a  brief  glance  what 
had  been  going  on  in  Europe  during  the  latter  part  of 
that  century,  the  first  quarter  of  which  had  been  made 
illustrious  in  the  history  of  medical  science  by  the  dis 
covery  of  the  circulation. 

Charles  Barbeyrac,  a  Protestant  in  his  religion,  was 
a  practitioner  and  teacher  of  medicine  at  Montpellier. 
His  creed  was  in  the  way  of  his  obtaining  office  ;  but 
the  young  men  followed  his  instructions  with  enthusi 
asm.  Religious  and  scientific  freedom  breed  in  and  in, 
until  it  becomes  hard  to  tell  the  family  of  one  from 
that  of  the  other.  Barbeyrac  threw  overboard  the  old 
complex  medical  farragos  of  the  pharmacopeias,  as  his 
church  had  disburdened  itself  of  the  popish  ceremonies. 

Among  the  students  who  followed  his  instructions 
were  two  Englishmen :  one  of  them,  John  Locke,  after 
wards  author  of  an  "  Essay  on  the  Human  Understand 
ing,"  three  years  younger  than  his  teacher ;  the  other, 
Thomas  Sydenham,  five  years  older.  Both  returned 
to  England.  Locke,  whose  medical  knowledge  is 
borne  witness  to  by  Sydenham,  had  the  good  fortune 
•  Thacher's  Med.  Biog.  p.  222.  *  Ibid.  p.  18. 


S44  MEDICAL  ESSAYS. 

to  form  a  correct  opinion  on  a  disease  from  which  the 
Earl  of  Shaftesbury  was  suffering,  which  led  to  an 
operation  that  saved  his  life.  Less  felicitous  was  his 
experience  with  a  certain  ancilla  culinaria  virgo,  — 
which  I  am  afraid  would  in  those  days  have  been  trans 
lated  kitchen-wench,  instead  of  lady  of  the  culinary 
department,  —  who  turned  him  off  after  she  had  got 
tired  of  him,  and  called  in  another  practitioner."  This 
helped,  perhaps,  to  spoil  a  promising  doctor,  and  make 
an  immortal  metaphysician.  At  any  rate,  Locke  laid 
down  the  professional  wig  and  cane,  and  took  to  other 
studies. 

The  name  of  Thomas  Sydenham  is  as  distinguished 
in  the  history  of  medicine  as  that  of  John  Locke  in 
philosophy.  As  Barbeyrac  was  found  in  opposition  to 
the  established  religion,  as  Locke  took  the  rational 
side  against  orthodox  Bishop  Stillingfleet,  so  Syden 
ham  went  with  Parliament  against  Charles,  and  was 
never  admitted  a  Fellow  by  the  College  of  Physicians, 
which,  after  he  was  dead,  placed  his  bust  in  their  hall 
by  the  side  of  that  of  Harvey. 

What  Sydenham  did  for  medicine  was  briefly  this : 
he  studied  the  course  of  diseases  carefully,  and  espe 
cially  as  affected  by  the  particular  season  ;  to  patients 
with  fever  he  gave  air  and  cooling  drinks,  instead  of 
smothering  and  heating  them,  with  the  idea  of  sweat 
ing  out  their  disease  ;  he  ordered  horseback  exercise  to 
consumptives  ;  he,  like  his  teacher,  used  few  and  com 
paratively  simple  remedies  ;  he  did  not  give  any  drug 
at  all,  if  he  thought  none  was  needed,  but  let  well 
enough  alone.  He  was  a  sensible  man,  in  short,  who 
applied  his  common  sense  to  diseases  which  he  had 

•  Locke  and  Sydenham,  p.  124.  By  John  Brown,  M.  D.  Edin 
bnrgh,  1866. 


THE  MEDICAL   PROFESSION   IN  MASSACHUSETTS.   345 

studied  with  the  best  light  of  science  that  he  could  ob 
tain. 

The  influence  of  the  reform  he  introduced  must 
have  been  more  or  less  felt  in  this  country,  but  not 
much  before  the  beginning  of  the  eighteenth  century, 
as  his  great  work  was  not  published  until  1675,  and 
then  in  Latin.  I  very  strongly  suspect  that  there  was 
not  so  much  to  reform  in  the  simple  practice  of  the 
physicians  of  the  new  community,  as  there  was  in  that 
of  the  learned  big-wigs  of  the  "  College,"  who  valued 
their  remedies  too  much  in  proportion  to  their  com 
plexity,  and  the  extravagant  and  fantastic  ingredients 
which  went  to  their  making. 

During  the  memorable  century  which  bred  and  bore 
the  Revolution,  the  medical  profession  gave  great 
names  to  our  history.  But  John  Brooks  belonged  to 
the  State,  and  Joseph  Warren  belongs  to  the  country 
and  mankind,  and  to  speak  of  them  would  lead  me 
beyond  my  limited  subject.  There  would  be  little 
pleasure  in  dwelling  on  the  name  of  Benjamin  Church ; 
and  as  for  the  medical  politicians,  like  Elisha  Cooke 
in  the  early  part  of  the  century,  or  Charles  Jarvis,  the 
"bald  eagle  of  Boston,"  in  its  later  years,  whether 
their  practice  was  heroic  or  not,  their  patients  were, 
for  he  is  a  bold  man  who  trusts  one  that  is  making 
speeches  and  coaxing  voters,  to  meddle  with  the  inter 
nal  politics  of  his  corporeal  republic. 

One  great  event  stands  out  in  the  medical  history  of 
this  eighteenth  century ;  namely,  the  introduction  of 
the  practice  of  inoculation  for  small-pox.  Six  epidem 
ics  of  this  complaint  had  visited  Boston  in  the  course 
of  a  hundred  years."  Prayers  had  been  asked  in  the 

•  W.  Douglass's  Diss,  Concerning  Inoc.  p.  25.     Boston,  1730, 


346  MEDICAL   ESSAYS. 

churches  for  more  than  a  hundred  sick  in  a  single 
day,  and  this  many  times.  About  a  thousand  persons 
had  died  in  a  twelvemonth,  we  are  told,  and,  as  we  may 
infer,  chiefly  from  this  cause." 

In  1721,  this  disease,  after  a  respite  of  nineteen 
years,  again  appeared  as  an  epidemic.  In  that  year  it 
was  that  Cotton  Mather,  browsing,  as  was  his  wont,  on 
all  the  printed  fodder  that  came  within  reach  of  his 
ever-grinding  mandibles,  came  upon  an  account  of  in 
oculation  as  practised  in  Turkey,  contained  in  the 
"  Philosophical  Transactions."  He  spoke  of  it  to  sev 
eral  physicians,  who  paid  little  heed  to  his  story ;  for 
they  knew  his  medical  whims,  and  had  probably  been 
bored,  as  we  say  now-a-days,  many  of  them,  with  list 
ening  to  his  "  Angel  of  Bethesda,"  and  satiated  with 
his  speculations  on  the  NishmatJi  Chajim. 

The  Reverend  Mather,  —  I  use  a  mode  of  expres 
sion  he  often  employed  when  speaking  of  his  honored 
brethren,  —  the  Reverend  Mather  was  right  this  time, 
and  the  irreverent  doctors  who  laughed  at  him  were 
wrong.  One  only  of  their  number  disputes  his  claim 
to  giving  the  first  impulse  to  the  practice  in  Boston. 
This  is  what  that  person  says  :  — 

"  The  Small-Pox  spread  in  Boston,  New  England, 
A.  1721,  and  the  Reverend  Dr.  Cotton  Mather,  having 
had  the  use  of  these  Communications  from  Dr.  Wil 
liam  Douglass  "  (that  is,  the  writer  of  these  words)  ; 
"surreptitiously,  without  the  knowledge  of  his  In 
former,  that  he  might  have  the  honour  of  a  New  f an 
gled  notion,  sets  an  Undaunted  Operator  to  work,  and 
in  this  Country  about  290  were  inoculated."  b 

All  this   has  not   deprived  Cotton  Mather  of  the 

•  Magnolia,  book  i.     "  The  Bostonian  Ebenezer." 

*  Dits.  Concerning  Inoculation,  p.  2. 


THE  MEDICAL  PROFESSION  IN  MASSACHUSETTS.    347 

credit  of  suggesting,  and  a  bold  and  intelligent  physi 
cian  of  the  honor  of  carrying  out,  the  new  practice. 
On  the  twenty-seventh  day  of  June,  1721,  Zabdiel 
Boylston  of  Boston  inoculated  his  only  son  for  small 
pox,  —  the  first  person  ever  submitted  to  the  operation 
in  the  New  World.  The  story  of  the  fierce  resistance 
to  the  introduction  of  the  practice ;  of  how  Boylston 
was  mobbed,  and  Mather  had  a  hand-grenade  thrown  in 
at  his  window  ;  of  how  William  Douglass,  the  Scotch 
man,  "always  positive,  and  sometimes  accurate,"  as 
was  neatly  said  of  him,  at  once  depreciated  the  prac 
tice  and  tried  to  get  the  credit  of  suggesting  it,  and 
how  Lawrence  Dalhonde,  the  Frenchman,  testified  to 
its  destructive  consequences ;  of  how  Edmund  Massey, 
lecturer  at  St.  Albans,  preached  against  sinfully  en 
deavoring  to  alter  the  course  of  nature  by  presumptu 
ous  interposition,  which  he  would  leave  to  the  atheist 
and  the  scoffer,  the  heathen  and  unbeliever,  while  in 
the  face  of  his  sermon,  afterwards  reprinted  in  Boston, 
many  of  our  New  England  clergy  stood  up  boldly  in 
defence  of  the  practice,  —  all  this  has  been  told  so 
well  and  so  often  that  I  spare  you  its  details.  Set  this 
good  hint  of  Cotton  Mather  against  that  letter  of  his 
to  John  Richards,  recommending  the  search  after 
witch-marks,  and  the  application  of  the  water-ordeal, 
which  means  throw  your  grandmother  into  the  water, 
if  she  has  a  mole  on  her  arm  ;  —  if  she  swims,  she  is  a 
witch  and  must  be  hanged ;  if  she  sinks,  the  Lord  have 
mercy  on  her  soul ! 

Thus  did  America  receive  this  great  discovery,  des 
tined  to  save  thousands  of  lives,  via  Boston,  from  the 
hands  of  one  of  our  own  Massachusetts  physicians. 

The  year  1735  was  rendered  sadly  memorable  by 
the  epidemic  of  the  terrible  disease  known  as  "  throat* 


848  MEDICAL   ESSAYS. 

distemper,"  and  regarded  by  many  as  the  same  as  our 
"  diphtheria."  Dr.  Holyoke  thinks  the  more  general 
use  of  mercurials  in  inflammatory  complaints  dates 
from  the  time  of  their  employment  in  this  disease,  in 
which  they  were  thought  to  have  proved  specially  use 
ful." 

At  some  tune  in  the  course  of  this  century  medical 
practice  had  settled  down  on  four  remedies  as  its  chief 
reliance.  I  must  repeat  an  incident  which  I  have  re 
lated  in  another  of  these  Essays.  When  Dr.  Holyoke, 
nearly  seventy  years  ago,  received  young  Mr.  James 
Jackson  as  his  student,  he  showed  him  the  formidable 
array  of  bottles,  jars,  and  drawers  around  his  office, 
and  then  named  the  four  remedies  referred  to  as  being 
of  more  importance  than  all  the  rest  put  together. 
These  were  Mercury,  Antimony,  Opium,  and  Peruvian 
Bark."  6  I  doubt  if  either  of  them  remembered  that, 
nearly  seventy  years  before,  in  1730,  Dr.  William 
Douglass,  the  disputatious  Scotchman,  mentioned  those 
same  four  remedies,  in  the  dedication  of  his  quarrel 
some  essay  on  inoculation,  as  the  most  important  ones 
in  the  hands  of  the  physicians  of  his  time. 

In  the  "  Proceedings"  of  this  Society  for  the  year 
1863  is  a  very  pleasant  paper  by  the  late  Dr.  Ephraim 
Eliot,  giving  an  account  of  the  leading  physicians  of 
Boston  during  the  last  quarter  of  the  last  century. 
The  names  of  Lloyd,  Gardiner,  Welsh,  Eand,  Bulfinch, 
Danforth,  John  Warren,  Jeffries,  are  all  famous  in 
local  history,  and  are  commemorated  in  our  medical 
biographies.  One  of  them,  at  least,  appears  to  have 
been  more  widely  known,  not  only  as  one  of  the  first 

"  Memoir  of  Edward  A.  Holyoke,  M.  Z>.,  LL.  D.,  p.  64.  Bos 
ton,  1829. 

6  Another  Letter  to  a  Young  Physician,  p.  15. 


THE  MEDICAL  PROFESSION  IN  MASSACHUSETTS.   349 

aerial  voyagers,  but  as  an  explorer  in  the  almost 
equally  hazardous  realm  of  medical  theory.  Dr.  John 
Jeffries,  the  first  of  that  name,  is  considered  by  Brous- 
sais  as  a  leader  of  medical  opinion  in  America,  and  so 
referred  to  in  his  famous  "  Examen  des  Doctrines 
Me'dicales." 

Two  great  movements  took  place  in  this  eighteenth 
century,  the  effect  of  which  has  been  chiefly  felt  in  our 
own  time  ;  namely,  the  establishment  of  the  Massachu 
setts  Medical  Society,  and  the  founding  of  the  Medical 
School  of  Harvard  University. 

The  third  century  of  our  medical  history  began  with 
the  introduction  of  the  second  great  medical  discovery 
of  modern  times,  —  of  all  time  up  to  that  date,  I  may 
say,  —  once  more  via  Boston,  if  we  count  the  Univer 
sity  village  as  its  suburb,  and  once  more  by  one  of 
our  Massachusetts  physicians.  In  the  month  of  July, 
1800,  Dr.  Benjamin  Waterhouse  of  Cambridge  sub 
mitted  four  of  his  own  children  to  the  new  process  of 
vaccination, — the  first  persons  vaccinated,  as  Dr.  Zab- 
diel  Boylston's  son  had  been  the  first  person  inoculated 
in  the  New  World. 

A  little  before  the  first  half  of  this  century  was  com 
pleted,  in  the  autumn  of  1846,  the  great  discovery 
went  forth  from  the  Massachusetts  General  Hospital, 
which  repaid  the  debt  of  America  to  the  science  of  the 
Old  World,  and  gave  immortality  to  the  place  of  its 
origin  in  the  memory  and  the  heart  of  mankind.  The 
production  of  temporary  insensibility  at  will  —  tuto, 
cito,  jucunde,  safely,  quickly,  pleasantly  —  is  one  of 
those  triumphs  over  the  infirmities  of  our  mortal  con 
dition  which  change  the  aspect  of  life  ever  afterwards. 
Rhetoric  can  add  nothing  to  its  glory ;  gratitude,  and 


850  MEDICAL  ESSAYS. 

the  pride  permitted  to  human  weakness,  that  our  Beth 
lehem  should  have  been  chosen  as  the  birthplace  of 
this  new  embodiment  of  the  divine  mercy,  are  all  we 
can  yet  find  room  for. 

The  present  century  has  seen  the  establishment  of 
all  those  great  charitable  institutions  for  the  cure  of 
diseases  of  the  body  and  of  the  mind,  which  our  State 
and  our  city  have  a  right  to  consider  as  among  the 
chief  ornaments  of  their  civilization. 

The  last  century  had  very  little  to  show,  in  OUT 
State,  in  the  way  of  medical  literature.  The  worthies 
who  took  care  of  our  grandfathers  and  great-grand 
fathers,  like  the  Revolutionary  heroes,  fought  (with 
disease)  and  bled  (their  patients)  and  died  (in  spite 
of  their  own  remedies) ;  but  their  names,  once  famil 
iar,  are  heard  only  at  rare  intervals.  Honored  in 
their  day,  not  unremembered  by  a  few  solitary  students 
of  the  past,  their  memories  are  going  sweetly  to  sleep 
in  the  arms  of  the  patient  old  dry-nurse,  whose  "  black- 
drop  "  is  the  never-failing  anodyne  of  the  restless  gen 
erations  of  men.  Except  the  lively  controversy  on 
inoculation,  and  floating  papers  in  journals,  we  have 
not  much  of  value  for  that  long  period,  in  the  shape  of 
medical  records. 

But  while  the  trouble  with  the  last  century  is  to  find 
authors  to  mention,  the  trouble  of  this  would  be  to  name 
all  that  we  find.  Of  these,  a  very  few  claim  unques 
tioned  preeminence. 

Nathan  Smith,  born  in  Rehoboth,  Mass.,  a  graduate 
of  the  Medical  School  of  our  University,  did  a  great 
work  for  the  advancement  of  medicine  and  surgery  in 
New  England,  by  his  labors  as  teacher  and  author, — 
greater,  it  is  claimed  by  some,  than  was  ever  done  by 
any  other  man.  The  two  Warrens,  of  our  time,  each 


THE  MEDICAL  PROFESSION  IN  MASSACHUSETTS.   351 

left  a  large  and  permanent  record  of  a  most  extended 
surgical  practice.  James  Jackson  not  only  educated  a 
whole  generation  by  his  lessons  of  wisdom,  but  be 
queathed  some  of  the  most  valuable  results  of  his  ex- 
perience  to  those  who  came  after  him,  hi  a  series  of 
letters  singularly  pleasant  and  kindly  as  well  as  in 
structive.  John  Ware,  keen  and  cautious,  earnest  and 
deliberate,  wrote  the  two  remarkable  essays  which  have 
identified  his  name,  for  all  tune,  with  two  important 
diseases,  on  which  he  has  shed  new  light  by  his  orig 
inal  observations. 

I  must  do  violence  to  the  modesty  of  the  living  by 
referring  to  the  many  important  contributions  to  medi 
cal  science  by  Dr.  Jacob  Bigelow,  and  especially  to 
his  discourse  on  "  Self-limited  Diseases,"  an  address 
which  can  be  read  in  a  single  hour,  but  the  influence 
of  which  will  be  felt  for  a  century. 

Nor  would  the  profession  forgive  me  if  I  forgot  to 
mention  the  admirable  museum  of  pathological  anat 
omy,  created  almost  entirely  by  the  hands  of  Dr. 
John  Barnard  Swett  Jackson,  and  illustrated  by  his 
own  printed  descriptive  catalogue,  justly  spoken  of  by 
a  distinguished  professor  in  the  University  of  Penn 
sylvania  as  the  most  important  contribution  which  had 
ever  been  made  in  this  country  to  the  branch  to  which 
it  relates. 

When  we  look  at  the  literature  of  mental  disease, 
as  seen  in  hospital  reports  and  special  treatises,  we 
can  mention  the  names  of  Wyman,  Woodward,  Brig- 
ham,  Bell,  and  Ray,  all  either  natives  of  Massachusetts 
or  placed  at  the  head  of  her  institutions  for  the  treat 
ment  of  the  insane. 

We  have  a  right  to  claim  also  one  who  is  known  all 
over  the  civilized  world  as  a  philanthropist,  to  us  as  a 


352  MEDICAL  ESSAYS. 

townsman  and  a  graduate  of  our  own  Medical  School, 
Dr.  Samuel  GricQey  Howe,  the  guide  and  benefacto* 
of  a  great  multitude  who  were  born  to  a  world  of  in 
ward  or  of  outward  darkness. 

I  cannot  pass  over  in  silence  the  part  taken  by  our 
own  physicians  in  those  sanitary  movements  which  are 
assuming  every  year  greater  importance.  Two  dis 
eases  especially  have  attracted  attention,  above  all 
others,  with  reference  to  their  causes  and  prevention ; 
cholera,  the  "  black  death  "  of  the  nineteenth  century, 
and  consumption,  the  white  plague  of  the  North,  both  of 
which  have  been  faithfully  studied  and  reported  on  by 
physicians  of  our  own  State  and  city.  The  cultivation 
of  medical  and  surgical  specialties,  which  is  fast  becom 
ing  prevalent,  is  beginning  to  show  its  effects  in  the 
literature  of  the  profession,  which  is  every  year  grow 
ing  richer  in  original  observations  and  investigations. 

To  these  benefactors  who  have  labored  for  us  in 
their  peaceful  vocation,  we  must  add  the  noble  army  of 
surgeons,  who  went  with  the  soldiers  who  fought  the 
battles  of  their  country,  sharing  many  of  their  dan 
gers,  not  rarely  falling  victims  to  fatigue,  disease,  or 
the  deadly  volleys  to  which  they  often  exposed  them 
selves  in  the  discharge  of  their  duties. 

The  pleasant  biographies  of  the  venerable  Dr. 
Thacher,  and  the  worthy  and  kind-hearted  gleaner, 
Dr.  Stephen  W.  Williams,  who  came  after  him,  are 
filled  with  the  names  of  men  who  served  their  gener 
ation  well,  and  rest  from  their  labors,  followed  by  the 
blessing  of  those  for  whom  they  endured  the  toils  and 
fatigues  inseparable  from  their  calling.  The  hard 
working,  intelligent  country  physician  more  especially 
deserves  the  gratitude  of  his  own  generation,  for  he 
rarely  leaves  any  permanent  record  in  the  literature 


THE  MEDICAL  PROFESSION  EST  MASSACHUSETTS.   353 

of  his  profession.  Books  are  hard  to  obtain ;  hospitals, 
which  are  always  centres  of  intelligence,  are  remote ; 
thoroughly  educated  and  superior  men  are  separated 
by  wide  intervals ;  and  long  rides,  though  favorable  to 
reflection,  take  up  much  of  the  time  which  might  other 
wise  be  given  to  the  labors  of  the  study.  So  it  is  that 
men  of  ability  and  vast  experience,  like  the  late  Dr. 
Twitchcll,  for  instance,  make  a  great  and  deserved  rep~ 
utation,  become  the  oracles  of  large  districts,  and  yet 
leave  nothing,  or  next  to  nothing,  by  which  their  names 
shall  be  preserved  from  blank  oblivion. 

One  or  two  other  facts  deserve  mention,  as  showing 
the  readiness  of  our  medical  community  to  receive  and 
adopt  any  important  idea  or  discovery.  The  new  sci 
ence  of  Histology,  as  it  is  now  called,  was  first  brought 
fully  before  the  profession  of  this  country  by  the  trans 
lation  of  Bichat's  great  work,  "  Anatomie  Ge'ne'rale," 
by  the  late  Dr.  George  Hayward. 

The  first  work  printed  in  this  country  on  Auscul 
tation^ —  that  wonderful  art  of  discovering  disease, 
which,  as  it  were,  puts  a  window  in  the  breast,  through 
which  the  vital  organs  can  be  seen,  to  all  intents  and 
purposes,  —  was  the  manual  published  anonymously  by 
"  A  Member  of  the  Massachusetts  Medical  Society." 

We  are  now  in  some  slight  measure  prepared  to 
weigh  the  record  of  the  medical  profession  in  'Massa 
chusetts,  and  pass  our  judgment  upon  it.  But  in  order 
to  do  justice  to  the  first  generation  of  practitioners, 
we  must  compare  what  we  know  of  their  treatment  of 
disease  with  the  state  of  the  art  in  England,  and  the 
superstitions  which  they  saw  all  around  them  in  other 
departments  of  knowledge  or  belief. 

English  medical  literature  must  have  been  at  a 


854  MEDICAL  ESSAYS. 

pretty  low  ebb  when  Sydenham  recommended  Don 
Quixote  to  Sir  Richard  Blackmore  for  professional 
reading.  The  College  Pharmacopoeia  was  loaded  with 
the  most  absurd  compound  mixtures,  one  of  the  most 
complex  of  which  (the  same  which  the  Reverend  Mr. 
Harward,  "  Lecturer  at  the  Royal  Chappel  in  Boston," 
tried  to  simplify)  was  not  dropped  until  the  year  1801. 
Sir  Kenelm  Digby  was  playing  his  fantastic  tricks  with 
the  Sympathetic  powder,  and  teaching  Governor  Win- 
throp,  the  second,  how  to  cure  fever  and  ague,  which 
some  may  like  to  know.  Pare  the  patient's  nails ;  put 
the  parings  in  a  little  bag,  and  hang  the  bag  round  the 
neck  of  a  live  eel,  and  put  him  in  a  tub  of  water. 
The  eel  will  die,  and  the  patient  will  recover." 

Wiseman,  the  great  surgeon,  was  discoursing  elo 
quently  on  the  efficacy  of  the  royal  touch  in  scrofula.6 
The  founder  of  the  Ashmolean  Museum  at  Oxford, 
consorting  with  alchemists  and  astrologers,  was  treas 
uring  the  manuscripts  of  the  late  pious  Dr.  Richard 
Napier,  in  which  certain  letters  Qty  Ris)  were  under 
stood  to  mean  Responsum  Raphaelis,  —  the  answer  of 
the  angel  Raphael  to  the  good  man's  medical  ques 
tions.0  The  illustrious  Robert  Boyle  was  making  his 
collection  of  choice  and  safe  remedies,  including  the 
sole  of  an  old  shoe,d  the  thigh  bone  of  a  hanged 
man,'  and  things  far  worse  than  these,  as  articles  of 
his  materia  medica.  Dr.  Stafford,  whose  paper  of 
directions  to  his  "  friend,  Mr.  Wintrop,"  I  cited,  was 

*  Hist.  Coll.  3d  Series,  vol.  x. 

*  Several  Chirurgicall  Treatises,  p.  245.     London,  1676. 

*  Turner  (William),  Remarkable  Providences,  part  i.  chap.  2. 
Also  referred  to  in  Mather's  MS.,  The  Angel  of  Bethesda. 

*  Medicinal  Experiments,  p.   105.      5th  edition.      London, 
1712. 

*  Ibid.  p.  105. 


THE  MEDICAL  PROFESSION  IN  MASSACHUSETTS.   855 

probably  a  man  of  standing  In  London ;  yet  toad- 
powder  was  his  sovereign  remedy. 

See  what  was  the  state  of  belief  in  other  matters 
among  the  most  intelligent  persons  of  the  colonies,  — 
magistrates  and  clergymen.  Jonathan  Brewster,  son 
of  the  church-elder,  writes  the  wildest  letters  to  John 
Winthrop  about  alchemy,  —  mad  for  making  gold  as 
the  Lynn  rock-borers  are  for  finding  it.a 

Remember  the  theology  and  the  diabology  of  the 
time.  Mr.  Cotton's  Theocracy  was  a  royal  govern 
ment,  with  the  King  of  kings  as  its  nominal  head,  but 
with  an  upper  chamber  of  saints,  and  a  tremendous 
opposition  in  the  lower  house ;  the  leader  of  which 
may  have  been  equalled,  but  cannot  have  been  sur 
passed  by  any  of  our  earth-born  politicians.  The  de 
mons  were  prowling  round  the  houses  every  night,  as 
the  foxes  were  sneaking  about  the  hen-roosts.  The 
men  of  Gloucester  fired  whole  flasks  of  gunpowder  at 
devils  disguised  as  Indians  and  Frenchmen.6 

How  deeply  the  notion  of  miraculous  interference 
with  the  course  of  nature  was  rooted,  is  shown  by  the 
tenacity  of  the  superstition  about  earthquakes.  We 
can  hardly  believe  that  our  Professor  Winthrop,  father 
of  the  old  judge  and  the  "  squire,"  whom  many  of  us 
Cambridge  people  remember  so  well,  had  to  defend 
himself  against  the  learned  and  excellent  Dr.  Prince, 
of  the  Old  South  Church,  for  discussing  their  phenom 
ena  as  if  they  belonged  to  the  province  of  natural  sci 
ence.* 

Not  for  the  sake  of  degrading  the  aspect  of  the 
noble  men  who  founded  our  State,  do  I  refer  to  their 

•  Hist.  Coll.  4th  Series,  vol.  vii.  pp.  72,  77. 

•  Magnolia,  book  vii.  art.  18. 

•  Two  Lectures  on  Comets,  p.  vii.    Boston,  1811. 


856  MEDICAL   ESSAYS. 

idle  beliefs  and  painful  delusions,  but  to  show  against 
what  influences  the  common  sense  of  the  medical  pro 
fession  had  to  assert  itself. 

Think,  then,  of  the  blazing  stars,  that  shook  their 
horrid  hair  in  the  sky ;  the  phantom  ship,  that  brought 
its  message  direct  from  the  other  world  ;  °  the  story  of 
the  mouse  and  the  snake  at  Watertown ;  6  of  the  mice 
and  the  prayer-book ;  *  of  the  snake  in  church ; d  of 
the  calf  with  two  heads ;  *  and  of  the  cabbage  "  in  the 
perfect  form  of  a  cutlash,"^ — all  which  innocent  oc 
currences  were  accepted  or  feared  as  alarming  pois 
tents. 

We  can  smile  at  these  :  but  we  cannot  smile  at  the 
account  of  unhappy  Mary  Dyer's  malformed  offspring ;  ° 
or  of  Mrs.  Hutchinson's  domestic  misfortune  of  similar 
character,*  in  the  story  of  which  the  physician,  Dr. 
John  Clark  of  Rhode  Island,  alone  appears  to  advan 
tage  ;  or  as  we  read  the  Rev.  Samuel  Willard's  fifteen 
alarming  pages  about  an  unfortunate  young  woman 
suffering  with  hysteria.*  Or  go  a  little  deeper  into 
tragedy,  and  see  poor  Dorothy  Talby,  mad  as  Ophelia, 
first  admonished,  then  whipped ;  at  last,  taking  her 
own  little  daughter's  life ;  put  on  trial,  and  standing 
mute,  threatened  to  be  pressed  to  death,  confessing, 

tt  Magnolia,  book  i.  chap.  6.     Winthrop,  Hist,  of  N.  E.  vol. 
ji.  p.  328. 

*  Life  and  Letters  of  John  Winthrop,  p.  108. 

*  Winthrop,  Hist,  of  N.  E.  vol.  ii.  p.  20. 

*  Ibid.  vol.  ii.  p.  880. 

*  Mather  Papers  in  Hist.  Soc.  Coll.  4th  Series,  vol.  viii.  p. 
614. 

'  Ibid.  «  Winthrop,  Hist.  ofN.  E.  vol.  i.  p.  261. 

*  Winthrop,  Hist.  ofN.  E.  p.  271. 

*  Case  of  Elizabeth  Knapp,  Hist.  Coll.  4th  Series,  vol.  viii 
p.  555. 


THE  MEDICAL  PROFESSION  IN   MASSACHUSETTS.   357 

sentenced,  praying  to  be  beheaded  ;  and  none  the  less 
pitilessly  swung  from  the  fatal  ladder.* 

The  cooper's  crazy  wife  —  crazy  in  the  belief  that 
she  has  committed  the  unpardonable  sin  —  tries  to 
drown  her  child,  to  save  it  from  misery ;  and  the  poor 
lunatic,  who  would  be  tenderly  cared  for  to-day  in  a 
quiet  asylum,  is  judged  to  be  acting  under  the  instiga 
tion  of  Satan  himself.6  Yet,  after  all,  what  can  we 
say,  who  put  Bunyan's  "  Pilgrim's  Progress,"  full  of 
nightmare  dreams  of  horror,  into  all  our  children's 
hands ;  a  story  in  which  the  awful  image  of  the  man 
in  the  cage  might  well  turn  the  nursery  where  it  is 
read  into  a  madhouse  ? 

The  miserable  delusion  of  witchcraft  illustrates,  in  a 
still  more  impressive  way,  the  false  ideas  which  gov 
erned  the  supposed  relation  of  men  with  the  spiritual 
world.  I  have  no  doubt  many  physicians  shared  in 
these  superstitions.  Mr.  Upham  says  they  —  that  is, 
some  of  them  —  were  in  the  habit  of  attributing  their 
want  of  success  to  the  fact,  that  an  "  evil  hand  "  was 
on  their  patient.*  The  temptation  was  strong,  no 
doubt,  when  magistrates  and  ministers  and  all  that 
followed  their  lead  were  contented  with  such  an  expla 
nation.  But  how  was  it  in  Salem,  according  to  Mr. 
Upham's  own  statement  ?  Dr.  John  Swinnerton  was, 
he  says,  for  many  years  the  principal  physician  of 
Salem/*  And  he  says,  also,  "  The  Swinnerton  family 
were  all  along  opposed  to  Mr.  Parris,  and  kept  re 
markably  clear  from  the  witchcraft  delusion."  e  Dr. 
John  Swinnerton  —  the  same,  by  the  way,  whose  mem- 

•  Winthrop,  Hist,  of  N.  E.  vol.  i.  p.  279. 

•  Ibid.  vol.  ii.  p.  65. 

•  Salem  Witchcraft,  vol.  ii.  p.  361.     Boston,  1867. 

•  Ibid.  vol.  i.  p.  140. 

•  Ibid.  vol.  ii.  p.  495  (Supplement). 


858  MEDICAL  ESSAYS. 

ory  is  illuminated  by  a  ray  from  the  genius  of  Haw 
thorne  —  died  the  very  year  before  the  great  witch* 
craft  explosion  took  place.  But  who  can  doubt  that  it 
was  from  him  that  the  family  had  learned  to  despise 
and  to  resist  the  base  superstition;  or  that  Bridget 
Bishop,  whose  house  he  rented,  as  Mr.  Upham  tells 
me,  the  first  person  hanged  in  the  time  of  the  delusion, 
would  have  found  an  efficient  protector  in  her  tenant, 
had  he  been  living,  to  head  the  opposition  of  his  fam 
ily  to  the  misguided  clergymen  and  magistrates  ? 

I  cannot  doubt  that  our  early  physicians  brought 
with  them  many  Old- World  medical  superstitions,  and 
I  have  no  question  that  they  were  more  or  less  involved 
in  the  prevailing  errors  of  the  community  in  which 
they  lived.  But,  on  the  whole,  their  record  is  a  clean 
one,  so  far  as  we  can  get  at  it ;  and  where  it  is  ques 
tionable  we  must  remember  that  there  must  have  been 
many  little-educated  persons  among  them ;  and  that 
all  must  have  felt,  to  some  extent,  the  influence  of 
those  sincere  and  devoted  but  unsafe  men,  the  physic- 
practising  clergymen,  who  often  used  spiritual  means 
as  a  substitute  for  temporal  ones,  who  looked  upon  a 
hysteric  patient  as  possessed  by  the  devil,  and  treated 
a  fractured  skull  by  prayers  and  plasters,  following  the 
advice  of  a  ruling  elder  in  opposition  to  the  unani 
mous  opinion  of  seven  surgeons." 

To  what  results  the  union  of  the  two  professions 
was  liable  to  lead,  may  be  seen  by  the  example  of  a 
learned  and  famous  person,  who  has  left  on  record  the 
product  of  his  labors  in  the  double  capacity  of  clergy 
man  and  physician. 

I  have  had  the  privilege  of  examining  a  manuscript 
of  Cotton  Mather's  relating  to  medicine,  by  the  kind- 

0  Winthrop's  History ',  vol.  ii.  p.  203.     The  child  recovered. 


THE  MEDICAL  PROFESSION  IN  MASSACHUSETTS.    359 

ness  of  the  librarian  of  the  American  Antiquarian  So 
ciety,  to  which  society  it  belongs.  A  brief  notice  of 
this  curious  document  may  prove  not  uninteresting. 

It  is  entitled  "  The  Angel  of  Bethesda :  an  Essay 
upon  the  Common  Maladies  of  Mankind,  offering, 
first,  the  sentiments  of  Piety,"  etc.,  etc.,  and  "  a  col 
lection  of  plain  but  potent  and  Approved  REMEDIES 
for  the  Maladies."  There  are  sixty-six  "  Capsula's," 
as  he  calls  them,  or  chapters,  in  his  table  of  contents  j 
of  which,  five  —  from  the  fifteenth  to  the  nineteenth, 
inclusive  —  are  missing.  This  is  a  most  unfortunate 
loss,  as  the  eighteenth  capsula  treated  of  agues,  and 
we  could  have  learned  from  it  something  of  their  de 
gree  of  frequency  in  this  part  of  New  England.  There 
is  no  date  to  the  manuscript ;  which,  however,  refers 
to  a  case  observed  Nov.  14,  1724. 

The  divine  takes  precedence  of  the  physician  in  this 
extraordinary  production.  He  begins  by  preaching  a 
sermon  at  his  unfortunate  patient.  Having  thrown 
him  into  a  cold  sweat  by  his  spiritual  sudorific,  he  at 
tacks  him  with  his  material  remedies,  which  are  often 
quite  as  unpalatable.  The  simple  and  cleanly  practice 
of  Sydenham,  with  whose  works  he  was  acquainted, 
seems  to  have  been  thrown  away  upon  him.  Every 
thing  he  could  find  mentioned  in  the  seventy  or  eighty 
authors  he  cites,  all  that  the  old  women  of  both  sexes 
had  ever  told  him  of,  gets  into  his  text,  or  squeezes  it 
self  into  his  margin. 

Evolving  disease  out  of  sin,  he  hates  it,  one  would 
say,  as  he  hates  its  cause,  and  would  drive  it  out  of  the 
body  with  all  noisome  appliances.  "  Sickness  is  in 
Fact  Flagellum  Dei  pro  peccatis  mundi"  So  saying, 
he  encourages  the  young  mother  whose  babe  is  wasting 
away  upon  her  breast  with  these  reflections  :  — 


360  MEDICAL   ESSAYS. 

"Think;  oil  the  grievous  Effects  of  Sin!  This 
wretched  Infant  has  not  arrived  unto  years  of  sense 
enough,  to  sin  after  the  similitude  of  the  transgres 
sion  committed  by  Adam.  Nevertheless  the  Trans 
gression  of  Adam,  who  had  all  mankind  Federally, 
yea,  Naturally,  in  him,  has  involved  this  Infant  in  the 
guilt  of  it.  And  the  poison  of  the  old  serpent,  which 
infected  Adam  when  he  fell  into  his  Transgression, 
by  hearkening  to  the  Tempter,  has  corrupted  all  man 
kind,  and  is  a  seed  unto  such  diseases  as  this  Infant  is 
now  laboring  under.  Lord,  what  are  we,  and  what 
are  our  children,  but  a  Generation  of  Vipers  ?  " 

Many  of  his  remedies  are  at  least  harmless,  but  his 
pedantry  and  utter  want  of  judgment  betray  them 
selves  everywhere.  He  piles  his  prescriptions  one 
upon  another,  without  the  least  discrimination.  He  is 
run  away  with  by  all  sorts  of  fancies  and  superstitions. 
He  prescribes  euphrasia,  eyebright,  for  disease  of  the 
eyes  ;  appealing  confidently  to  the  strange  old  doctrine 
of  signatures,  which  inferred  its  use  from  the  resem 
blance  of  its  flower  to  the  organ  of  vision.  For  the 
scattering  of  wens,  "  the  efficacy  of  a  Dead  Hand  has 
been  out  of  measure  wonderful."  But  when  he  once 
comes  to  the  odious  class  of  remedies,  he  revels  in  them 
like  a  scarabeus.  This  allusion  will  bring  us  quite 
near  enough  to  the  inconceivable  abominations  with 
which  he  proposed  to  outrage  the  sinful  stomachs  of 
the  unhappy  confederates  and  accomplices  of  Adam. 

It  is  well  that  the  treatise  was  never  printed,  yet 
there  are  passages  in  it  worth  preserving.  He  speaks 
of  some  remedies  which  have  since  become  more  uni 
versally  known:  — 

"  Among  the  plants  of  our  soyl,  Sir  William  Tem 
ple  singles  out  Five  [Six]  as  being  of  the  greatest  virtue 


THE  MEDICAL  PROFESSION  IN  MASSACHUSETTS.   361 

and  most  friendly  to  health  :  and  his  favorite  plants, 
Sage,  Rue,  Saffron,  Alehoof,  Garlick,  and  Elder." 

"  But  these  Five  [Six]  plants  may  admitt  of  some 
competitors.  The  QUINQUINA  —  How  celebrated :  Im 
moderately,  Hyperbolically  celebrated !  '* 

Of  Ipecacuanha,  he  says,  — 

"This  is  now  in  its  reign;  the  most  fashionable 
vomit." 

"  I  am  not  sorry  that  antimonial  emetics  begin  to  be 
disused." 

He  quotes  "  Mr.  Lock  "  as  recommending  red  pop 
py-water  and  abstinence  from  flesh  as  often  useful  in 
children's  diseases. 

One  of  his  "  Capsula's  "  is  devoted  to  the  animal* 
cular  origin  of  diseases,  at  the  end  of  which  he  says, 
speaking  of  remedies  for  this  supposed  source  of  our 
distempers :  — 

"  Mercury  we  know  thee :  But  we  are  afraid  thou 
wilt  kill  us  too,  if  we  employ  thee  to  kill  them  that 
kill  us. 

"  And  yett,  for  the  cleansing  of  the  small  Blood  Ves 
sels,  and  making  way  for  the  free  circulation  of  the 
Blood  and  Lymph  —  there  is  nothing  like  Mercurial 
Deobstruents. " 

From  this  we  learn  that  mercury  was  already  in  com 
mon  use,  and  the  subject  of  the  same  popular  prejudice 
as  in  our  own  time. 

His  poetical  turn  shows  itself  here  and  there  :  — 

"  O  Nightingale,  with  a  Thorn  at  thy  Breast ;  Under 
the  trouble  of  a  Cough,  what  can  be  more  proper  than 
such  thoughts  as  these  ?  "  .  .  . 

If  there  is  pathos  in  this,  there  is  bathos  in  his  apos 
trophe  to  the  millipede,  beginning  "  Poor  sowbug !  " 
and  eulogizing  the  healing  virtues  of  that  odious  little 


862  MEDICAL  ESSAYS. 

beast ;  of  which  he  tells  us  to  take  "  half  a  pound, 
putt  'em  alive  into  a  quart  or  two  of  wine,"  with  saf 
fron  and  other  drugs,  and  take  two  ounces  twice  a  day. 

The  "  Capsula  "  entitled  "  Nishmath  Chajim  "  waa 
printed  in  1722,  at  New  London,  and  is  in  the  posses 
sion  of  our  own  Society.  He  means,  by  these  words, 
something  like  the  Archaeus  of  Van  Helmont,  of  which 
he  discourses  in  a  style  wonderfully  resembling  that  of 
Mr.  Jenkinson  in  the  "  Vicar  of  Wakefield."  "  Many 
of  the  Ancients  thought  there  was  much  of  a  Real 
History  in  the  Parable,  and  their  Opinion  was  that 
there  is,  DIAPHOBA  KATA  TAS  MORPHAS,  A  Distinc 
tion  )(and  so  a  Resemblance)  of  men  as  to  their  /Shapes 
after  Death."  And  so  on,  with  Irenaeus,  Tertullian, 
Thespesius,  and  "  the  TA  TONE  PSEUCONE  CROMATA," 
in  the  place  of  "  Sanconiathon,  Manetho,  Berosus" 
and  "  Anarchon  ara  kai  ateleutaion  to  pan" 

One  other  passage  deserves  notice,  as  it  relates 
to  the  single  medical  suggestion  which  does  honor  to 
Cotton  Mather's  memory.  It  does  not  appear  that  he 
availed  himself  of  the  information  which  he  says  he 
obtained  from  his  slave,  for  such  I  suppose  he  was. 

In  his  appendix  to  "Variolse  Triumphatae,"  he 
says,  — 

"  There  has  been  a  wonderful  practice  lately  used 
in  several  parts  of  the  world,  which  indeed  is  not  yet 
become  common  in  our  nation. 

"  I  was  first  informed  of  it  by  a  Garamantee  servant 
of  my  own,  long  before  I  knew  that  any  Europeans 
or  Asiaticks  had  the  least  acquaintance  with  it,  and 
some  years  before  I  was  enriched  with  the  communica 
tions  of  the  learned  Foreigners,  whose  accounts  I  found 
agreeing  with  what  I  received  of  my  servant,  when  he 
shewed  me  the  Scar  of  the  Wound  made  for  the  opera- 


THE  MEDICAL  PROFESSION  IN  MASSACHUSETTS.   363 

tion  ;  and  said,  That  no  person  ever  died  of  the  small 
pox,  in  their  countrey,  that  had  the  courage  to  use  it. 

"  I  have  since  met  with  a  considerable  Number  of 
these  Africans,  who  all  agree  in  one  story ;  That  in 
their  countrey  grandy-many  dy  of  the  small-pox  :  But 
now  they  learn  this  way :  people  take  juice  of  small 
pox  and  cutty-skin  and  put  in  a  Drop ;  then  by  'nd  by 
a  little  sicky,  sicky:  then  very  few  little  things  like 
small-pox ;  and  nobody  dy  of  it ;  and  nobody  have 
small-pox  any  more.  Thus,  in  Africa,  where  the  poor 
creatures  dy  of  the  small-pox  like  Rotten  Sheep,  a 
merciful  God  has  taught  them  an  Infallible  preserva 
tive.  'T  is  a  common  practice,  and  is  attended  with  a 
constant  success" 

What  has  come  down  to  us  of  the  first  century  of 
medical  practice,  in  the  hands  of  Winthrop  and  Oliver, 
is  comparatively  simple  and  reasonable.  I  suspect 
that  the  conditions  of  rude,  stern  life,  in  which  the 
colonists  found  themselves  in  the  wilderness,  took  the 
nonsense  out  of  them,  as  the  exigencies  of  a  campaign 
did  out  of  our  physicians  and  surgeons  in  the  late  war. 
Good  food  and  enough  of  it,  pure  air  and  water,  clean 
liness,  good  attendance,  an  anaesthetic,  an  opiate,  a 
stimulant,  quinine,  and  two  or  three  common  drugs, 
proved  to  be  the  marrow  of  medical  treatment ;  and 
the  fopperies  of  the  pharmacopoeia  went  the  way  of 
embroidered  shirts  and  white  kid  gloves  and  malacca 
joints,  in  their  time  of  need.  "  Good  wine  is  the  best 
cordiall  for  her,"  said  Governor  John  Winthrop,  Jun 
ior,  to  Samuel  Symonds,  speaking  of  that  gentleman's 
wife,  —  just  as  Sydenham,  instead  of  physic,  once  or 
dered  a  roast  chicken  and  a  pint  of  canary  for  hia 
patient  in  male  hysterics. 

But  the  profession  of  medicine  never  could  reach  its 


864  MEDICAL  ESSAYS. 

full  development  until  it  became  entirely  separated 
from  that  of  divinity.  The  spiritual  guide,  the  con 
soler  in  affliction,  the  confessor  who  is  admitted  into 
the  secrets  of  our  souls,  has  his  own  noble  sphere  of 
duties;  but  the  healer  of  men  must  confine  himself 
solely  to  the  revelations  of  God  in  nature,  as  he  sees 
their  miracles  with  his  own  eyes.  No  doctrine  of 
prayer  or  special  providence  is  to  be  his  excuse  for  not 
looking  straight  at  secondary  causes,  and  acting,  exactly 
so  far  as  experience  justifies  him,  as  if  he  were  him 
self  the  divine  agent  which  antiquity  fabled  him  to  be. 
While  pious  men  were  praying — humbly,  sincerely, 
rightly,  according  to  their  knowledge  —  over  the  end 
less  succession  of  little  children  dying  of  spasms  in  the 
great  Dublin  Hospital,  a  sagacious  physician  knocked 
some  holes  in  the  walls  of  the  ward,  let  God's  blessed 
air  in  on  the  little  creatures,  and  so  had  already  saved 
in  that  single  hospital,  as  it  was  soberly  calculated 
thirty  years  ago,  more  than  sixteen  thousand  lives  of 
these  infant  heirs  of  immortality." 

Let  it  be,  if  you  will,  that  the  wise  inspiration  of  the 
physician  was  granted  in  virtue  of  the  clergyman's  sup 
plications.  Still,  the  habit  of  dealing  with  things 
seen  generates  another  kind  of  knowledge,  and  an 
other  way  of  thought,  from  that  of  dealing  with  things 
unseen ;  which  knowledge  and  way  of  thought  are 
special  means  granted  by  Providence,  and  to  be  thank 
fully  accepted. 

The  mediaeval  ecclesiastics  expressed  a  great  truth 
in  that  saying,  so  often  quoted,  as  carrying  a  reproach 
with  it:  "  Ubi  tres  mediti,  duo  aihei"  —  "Where 
there  are  three  physicians,  there  are  two  atheists." 

'  Collins's  Midwifery,  p.  812.  Published  by  order  of  the 
Massachusetts  Medical  Society.  Boston,  1841. 


THE  MEDICAL  PROFESSION  IN  MASSACHUSETTS.   365 

It  was  true  then,  it  is  true  to-day,  that  the  physician 
very  commonly,  if  not  very  generally,  denies  and  repu 
diates  the  deity  of  ecclesiastical  commerce.  The  Being 
whom  Ambroise  Par£  meant  when  he  spoke  those  memo 
rable  words,  which  you  may  read  over  the  professor's 
chair  in  the  French  School  of  Medicine,  —  "  Je  le  pen- 
say,  et  Dieu  le  guarit"  —  "I  dressed  his  wound,  and 
God  healed  it," — is  a  different  being  from  the  God  that 
scholastic  theologians  have  projected  from  their  con 
sciousness,  or  shaped  even  from  the  sacred  pages  which 
have  proved  so  plastic  in  their  hands.  He  is  a  God 
who  never  leaves  himself  without  witness,  who  repent- 
eth  him  of  the  evil,  who  never  allows  a  disease  or  an 
injury,  compatible  with  the  enjoyment  of  life,  to  take 
its  course  without  establishing  an  effort,  limited  by 
certain  fixed  conditions,  it  is  true,  but  an  effort,  always, 
to  restore  the  broken  body  or  the  shattered  mind.  In 
the  perpetual  presence  of  this  great  Healing  Agent, 
who  stays  the  bleeding  of  wounds,  who  knits  the  frac 
tured  bone,  who  expels  the  splinter  by  a  gentle  natural 
process,  who  walls  in  the  inflammation  that  might  in 
volve  the  vital  organs,  who  draws  a  cordon  to  separate 
the  dead  part  from  the  living,  who  sends  his  three 
natural  anaesthetics  to  the  overtasked  frame  in  due 
order,  according  to  its  need,  —  sleep,  fainting,  death  ; 
in  this  perpetual  presence,  it  is  doubtless  hard  for  the 
physician  to  realize  the  theological  fact  of  a  vast  and 
permanent  sphere  of  the  universe,  where  no  organ  finds 
itself  in  its  natural  medium,  where  no  wound  heals 
kindly,  where  the  executive  has  abrogated  the  pardon 
ing  power,  and  mercy  forgets  its  errand ;  where  the 
omnipotent  is  unfelt  save  in  malignant  agencies,  and 
the  omnipresent  is  unseen  and  unrepresented ;  hard  to 
accept  the  God  of  Dante's  "  Inferno,"  and  of  Bunyan'a 


366  MEDICAL  ESSAYS. 

caged  lunatic.  If  this  is  atheism,  call  three,  instead 
of  two  of  the  trio,  atheists,  and  it  will  probably  come 
nearer  the  truth. 

I  am  not  disposed  to  deny  the  occasional  injurious 
effect  of  the  materializing  influences  to  which  the  phy 
sician  is  subjected.  A  spiritual  guild  is  absolutely 
necessary  to  keep  him,  to  keep  us  all,  from  becoming 
the  "fingering  slaves"  that  Wordsworth  treats  with 
such  shrivelling  scorn.  But  it  is  well  that  the  two 
callings  have  been  separated,  and  it  is  fitting  that  they 
remain  apart.  In  settling  the  affairs  of  the  late  con., 
cern,  I  am  afraid  our  good  friends  remain  a  little  in 
our  debt.  We  lent  them  our  physician  Michael  Ser- 
vetus  in  fair  condition,  and  they  returned  him  so  dam 
aged  by  fire  as  to  be  quite  useless  for  our  purposes. 
Their  Reverend  Samuel  Willard  wrote  us  a  not  over- 
wise  report  of  a  case  of  hysteria  ;  and  our  Jean  Astruo 
gave  them  (if  we  may  trust  Dr.  Smith's  Dictionary  of 
the  Bible)  the  first  discerning  criticism  on  the  author 
ship  of  the  Pentateuch.  Our  John  Locke  enlightened 
them  with  his  letters  concerning  toleration  ;  and  their 
Cotton  Mather  obscured  our  twilight  with  his  "  Nish- 
math  Chajim." 

Yet  we  must  remember  that  the  name  of  Basil  Val 
entine,  the  monk,  is  associated  with  whatever  good  and 
harm  we  can  ascribe  to  antimony ;  and  that  the  most 
remarkable  of  our  specifics  long  bore  the  name  of 
*'  Jesuit's  Bark,"  from  an  old  legend  connected  with 
its  introduction.  "  Frere  Jacques,"  who  taught  the 
lithotomists  of  Paris,  owes  his  ecclesiastical  title  to 
courtesy,  as  he  did  not  belong  to  a  religious  order. 

Medical  science,  and  especially  the  study  of  mental 
disease,  is  destined,  I  believe,  to  react  to  much  greater 
advantage  on  the  theology  of  the  future  than  theology 


THE  MEDICAL  PROFESSION  IN  MASSACHUSETTS.    367 

Las  acted  on  medicine  in  the  past.  The  liberal  spirit 
very  generally  prevailing  in  both  professions,  and  the 
good  understanding  between  their  most  enlightened 
members,  promise  well  for  the  future  of  both  in  a  com 
munity  which  holds  every  point  of  human  belief, 
every  institution  in  human  hands,  and  every  word 
written  in  a  human  dialect,  open  to  free  discussion  to 
day,  to-morrow,  and  to  the  end  of  time.  Whether  the 
world  at  large  will  ever  be  cured  of  trusting  to  spe 
cifics  as  a  substitute  for  observing  the  laws  of  health, 
and  to  mechanical  or  intellectual  formulae  as  a  substi 
tute  for  character,  may  admit  of  question.  Quackery 
and  idolatry  are  all  but  immortal. 

We  can  find  most  of  the  old  beliefs  alive  amongst 
us  to-day,  only  having  changed  their  dresses  and  the 
social  spheres  in  which  they  thrive.  We  think  the 
quarrels  of  Galenists  and  chemists  belong  to  the  past, 
forgetting  that  Thomsonism  has  its  numerous  apostles 
in  our  community  ;  that  it  is  common  to  see  remedies 
vaunted  as  purely  vegetable,  and  that  the  prejudice 
against  "mineral  poisons,"  especially  mercury,  is  as 
strong  in  many  quarters  now  as  it  was  at  the  begin 
ning  of  the  seventeenth  century.  Names  are  only  air, 
and  blow  away  with  a  change  of  wind  ;  but  beliefs  are 
rooted  in  human  wants  and  weakness,  and  die  hard. 
The  oaks  of  Dodona  are  prostrate,  and  the  shrine  of 
Delphi  is  desolate ;  but  the  Pythoness  and  the  Sibyl 
may  be  consulted  in  Lowell  Street  for  a  very  moderate 
compensation.  Nostradamus  and  Lilly  seem  impossi 
ble  in  our  time  ;  but  we  have  seen  the  advertisements 
of  an  astrologer  in  our  Boston  papers  year  after  year, 
which  seems  to  imply  that  he  found  believers  and  pa 
trons.  You  smiled  when  I  related  Sir  Kenelm  Digby's 
prescription  with  the  live  eel  in  it ;  but  if  each  of  you 


MEDICAL  ESSAYS. 

were  to  empty  his  or  her  pockets,  would  there  not  roll 
out,  from  more  than  one  of  them,  a  horse-chestnut,  car 
ried  about  as  a  cure  for  rheumatism  ?  The  brazen 
head  of  Roger  Bacon  is  mute ;  but  is  not  "  Plan- 
chette  "  uttering  her  responses  in  a  hundred  houses  of 
this  city  ?  We  think  of  palmistry  or  chiromancy  as 
belonging  to  the  days  of  Albertus  Magnus,  or,  if  exist 
ing  in  our  time,  as  given  over  to  the  gypsies ;  but  a 
very  distinguished  person  has  recently  shown  me  the 
line  of  life,  and  the  line  of  fortune,  on  the  palm  of  his 
hand,  with  a  seeming  confidence  in  the  sanguine  pre 
dictions  of  his  career  which  had  been  drawn  from 
them.  What  shall  we  say  of  the  plausible  and  well- 
dressed  charlatans  of  our  own  time,  who  trade  in  false 
pretences,  like  Nicholas  Knapp  of  old,  but  without  any 
fear  of  being  fined  or  whipped ;  or  of  the  many  follies 
and  inanities,  imposing  on  the  credulous  part  of  the 
community,  each  of  them  gaping  with  eager,  open 
mouth  for  a  gratuitous  advertisement  by  the  mention 
of  its  foolish  name  in  any  respectable  connection  ? 

I  turn  from  this  less  pleasing  aspect  of  the  common 
intelligence  which  renders  such  follies  possible,  to  close 
the  honorable  record  of  the  medical  profession  in  this, 
our  ancient  Commonwealth. 

We  have  seen  it  in  the  first  century  divided  among 
clergymen,  magistrates,  and  regular  practitioners ;  yet, 
on  the  whole,  for  the  time,  and  under  the  circum 
stances,  respectable,  except  where  it  invoked  supernat 
ural  agencies  to  account  for  natural  phenomena. 

In  the  second  century  it  simplified  its  practice,  edu 
cated  many  intelligent  practitioners,  and  began  the 
work  of  organizing  for  concerted  action,  and  for  medi 
cal  teaching. 

In  this,  our  own  century,  it  has  built  hospitals,  per- 


THE  MEDICAL  PROFESSION  IN  MASSACHUSETTS.   369 

fected  and  multiplied  its  associations  and  educational 
institutions,  enlarged  and  created  museums,  and  chal 
lenged  a  place  in  the  world  of  science  by  its  literature. 
In  reviewing  the  whole  course  of  its  history  we  read 
a  long  list  of  honored  names,  and  a  precious  record 
written  in  private  memories,  in  public  charities,  in 
permanent  contributions  to  medical  science,  in  gener 
ous  sacrifices  for  the  country.  We  can  point  to  our 
capital  as  the  port  of  entry  for  the  New  World  of  the 
great  medical  discoveries  of  two  successive  centuries, 
and  we  can  claim  for  it  the  triumph  over  the  most 
dreaded  foe  that  assails  the  human  body,  —  a  triumph 
which  the  annals  of  the  race  can  hardly  match  in  three 
thousand  years  of  medical  history. 


VII. 
THE  YOUNG  PRACTITIONER.* 

THE  occasion  which  calls  us  together  reminds  us 
not  a  little  of  that  other  ceremony  which  unites  a  man 
and  woman  for  life.  The  banns  have  already  been 
pronounced  which  have  wedded  our  young  friends  to 
the  profession  of  their  choice.  It  remains  only  to  ad 
dress  to  them  some  friendly  words  of  cheering  coun 
sel,  and  to  bestow  upon  them  the  parting  benediction. 

This  is  not  the  time  for  rhetorical  display  or  ambi 
tious  eloquence.  We  must  forget  ourselves,  and  think 
only  of  them.  To  us  it  is  an  occasion ;  to  them  it  is 
an  epoch.  The  spectators  at  the  wedding  look  curi 
ously  at  the  bride  and  bridegroom  ;  at  the  bridal  veil, 
the  orange-flower  garland,  the  giving  and  receiving  of 
the  ring ;  they  listen  for  the  tremulous  "  I  will,"  and 
wonder  what  are  the  mysterious  syllables  the  clergy 
man  whispers  in  the  ear  of  the  married  maiden.  But 
to  the  newly-wedded  pair  what  meaning  in  those 
words,  "  for  better,  for  worse,"  "  in  sickness  and  in 
health,"  "  till  death  us  do  part !  "  To  the  father,  to 
the  mother,  who  know  too  well  how  often  the  deadly 
nightshade  is  interwoven  with  the  wreath  of  orange- 
blossoms,  how  empty  the  pageant,  how  momentous  the 
reality ! 

You  will  not  wonder  that  I  address  myself  chiefly  to 

•  A  Valedictory  Address  delivered  to  the  Graduating  Class  ol 
the  Bellevue  Hospital  College,  March  2,  1871. 


THE  YOUNG  PRACTITIONER.  371 

those  who  are  just  leaving  academic  life  for  the  sterner 
struggle  and  the  larger  tasks  of  matured  and  in 
structed  manhood.  The  hour  belongs  to  them  ;  if  oth 
ers  find  patience  to  listen,  they  will  kindly  remember 
that,  after  all,  they  are  but  as  the  spectators  at  the 
wedding,  and  that  the  priest  is  thinking  less  of  them 
than  of  their  friends  who  are  kneeling  at  the  altar. 

I  speak  more  directly  to  you,  then,  gentlemen  of  the 
graduating  class.  The  days  of  your  education,  as  pu 
pils  of  trained  instructors,  are  over.  Your  first  har 
vest  is  all  garnered.  Henceforth  you  are  to  be  sowers 
as  well  as  reapers,  and  your  field  is  the  world.  How 
does  your  knowledge  stand  to-day  ?  What  have  you 
gained  as  a  permanent  possession  ?  What  must  you 
expect  to  forget  ?  What  remains  for  you  yet  to  learn  ? 
These  are  questions  which  it  may  interest  you  to  con 
sider. 

There  is  another  question  which  must  force  itself 
on  the  thoughts  of  many  among  you :  "  How  am  I  to 
obtain  patients  and  to  keep  their  confidence  ?  "  You 
have  chosen  a  laborious  calling,  and  made  many  sacri 
fices  to  fit  yourselves  for  its  successful  pursuit.  You 
wish  to  be  employed  that  you  may  be  useful,  and  that 
you  may  receive  the  reward  of  your  industry.  I  would 
take  advantage  of  these  most  receptive  moments  to 
give  you  some  hints  which  may  help  you  to  realize 
your  hopes  and  expectations.  Such  is  the  outline  of 
the  familiar  talk  I  shall  offer  you. 

Your  acquaintance  with  some  of  the  accessory 
branches  is  probably  greater  now  than  it  will  be  in  a 
year  from  now, — much  greater  than  it  will  be  ten 
years  from  now.  The  progress  of  knowledge,  it  may 
be  feared,  or  hoped,  will  have  outrun  the  text-books  in 
which  you  studied  these  branches.  Chemistry,  for  in- 


872  MEDICAL  ESSAYS. 

stance,  is  very  apt  to  spoil  on  one's  hands.  "Nou& 
avons  changS  tout  celd  "  might  serve  as  the  standing 
motto  of  many  of  our  manuals.  Science  is  a  great 
traveller,  and  wears  her  shoes  out  pretty  fast,  as  might 
be  expected. 

You  are  now  fresh  from  the  lecture-room  and  the 
laboratory.  You  can  pass  an  examination  in  anatomy, 
physiology,  chemistry,  materia  medica,  which  the  men 
in  large  practice  all  around  you  would  find  a  more  po 
tent  sudorific  than  any  in  the  Pharmacopoeia.  These 
masters  of  the  art  of  healing  were  once  as  ready  with 
their  answers  as  you  are  now,  but  they  have  got  rid  of 
a  great  deal  of  the  less  immediately  practical  part  of 
their  acquisitions,  and  you  must  undergo  the  same  de 
pleting  process.  Hard  work  will  train  it  off,  as  sharp 
exercise  trains  off  the  fat  of  a  prize-fighter. 

Yet,  pause  a  moment  before  you  infer  that  your 
teachers  must  have  been  in  fault  when  they  furnished 
you  with  mental  stores  not  directly  convertible  to 
practical  purposes,  and  likely  in  a  few  years  to  lose 
their  place  in  your  memory.  All  systematic  knowl 
edge  involves  much  that  is  not  practical,  yet  it  is  the 
only  kind  of  knowledge  which  satisfies  the  mind,  and 
systematic  study  proves,  in  the  long-run,  the  easiest 
way  of  acquiring  and  retaining  facts  which  are  prac 
tical.  There  are  many  things  which  we  can  afford  to 
forget,  which  yet  it  was  well  to  learn.  Your  men 
tal  condition  is  not  the  same  as  if  you  had  never  known 
what  you  now  try  in  vain  to  recall.  There  is  a  per 
petual  metempsychosis  of  thought,  and  the  knowledge 
of  to-day  finds  a  soil  in  the  forgotten  facts  of  yester 
day.  You  cannot  see  anything  in  the  new  season  of 
the  guano  you  placed  last  year  about  the  roots  of  your 
climbing  plants,  but  it  is  blushing  and  breathing  fra 


THE  YOUNG  PKACTITIONEB.  373 

grance  in  your  trellised  roses ;  it  has  scaled  your  porch 
in  the  bee-haunted  honey-suckle ;  it  has  found  its  way 
where  the  ivy  is  green ;  it  is  gone  where  the  woodbine 
expands  its  luxuriant  foliage. 

Your  diploma  seems  very  broad  to-day  with  your  list 
of  accomplishments,  but  it  begins  to  shrink  from  this 
hour  like  the  Peau  de  Chagrin  of  Balzac's  story. 
Do  not  worry  about  it,  for  all  the  while  there  will  be 
making  out  for  you  an  ampler  and  fairer  parchment, 
signed  by  old  Father  Time  himself  as  President  of 
that  great  University  in  which  experience  is  the  one 
perpetual  and  all-sufficient  professor. 

Your  present  plethora  of  acquirements  will  soon 
cure  itself.  Knowledge  that  is  not  wanted  dies  out 
like  the  eyes  of  the  fishes  of  the  Mammoth  Cave. 
When  you  come  to  handle  life  and  death  as  your 
daily  business,  your  memory  will  of  itself  bid  good-by 
to  such  inmates  as  the  well-known  foramina  of  the 
sphenoid  bone  and  the  familiar  oxides  of  methyl-ethyl- 
amyl-phenyl-ammonium.  Be  thankful  that  you  have 
once  known  them,  and  remember  that  even  the  learned 
ignorance  of  a  nomenclature  is  something  to  have  mas 
tered,  and  may  furnish  pegs  to  hang  facts  upon  which 
would  otherwise  have  strewed  the  floor  of  memory  in 
loose  disorder. 

But  your  education  has,  after  all,  been  very  largely 
practical.  You  have  studied  medicine  and  surgery, 
not  chiefly  in  books,  but  at  the  bedside  and  in  the 
operating  amphitheatre.  It  is  the  special  advantage 
of  large  cities  that  they  afford  the  opportunity  of  see 
ing  a  great  deal  of  disease  in  a  short  space  of  time, 
and  of  seeing  many  cases  of  the  same  kind  of  disease 
brought  together.  Let  us  not  be  unjust  to  the  claims 
of  the  schools  remote  from  the  larger  centres  of  popu- 


374  MEDICAL  ESSAYS. 

lation.  Who  among  us  has  taught  better  than  Nathan 
Smith,  better  than  Elisha  Bartlett  ?  who  teaches  better 
than  some  of  our  living  contemporaries  who  divide 
their  time  between  city  and  country  schools  ?  I  am 
afraid  we  do  not  always  do  justice  to  our  country 
brethren,  whose  merits  are  less  conspicuously  exhibited 
than  those  of  the  great  city  physicians  and  surgeons, 
such  especially  as  have  charge  of  large  hospitals.  There 
are  modest  practitioners  living  in  remote  rural  districts 
who  are  gifted  by  nature  with  such  sagacity  and  wis 
dom,  trained  so  well  in  what  is  most  essential  to  the 
practice  of  their  art,  taught  so  thoroughly  by  varied 
experience,  forced  to  such  manly  self-reliance  by  their 
comparative  isolation,  that,  from  converse  with  them 
alone,  from  riding  with  them  on  their  long  rounds  as 
they  pass  from  village  to  village,  from  talking  over 
cases  with  them,  putting  up  their  prescriptions,  watch 
ing  their  expedients,  listening  to  their  cautions,  mark 
ing  the  event  of  their  predictions,  hearing  them  tell  of 
their  mistakes,  and  now  and  then  glory  a  little  in  the 
detection  of  another's  blunder,  a  young  man  would  find 
himself  better  fitted  for  his  real  work  than  many  who 
have  followed  long  courses  of  lectures  and  passed  a 
showy  examination.  But  the  young  man  is  exception 
ally  fortunate  who  enjoys  the  intimacy  of  such  a  teacher. 
And  it  must  be  confessed  that  the  great  hospitals,  in 
firmaries,  and  dispensaries  of  large  cities,  where  men 
of  well-sifted  reputations  are  in  constant  attendance, 
are  the  true  centres  of  medical  education.  No  stu 
dents,  I  believe,  are  more  thoroughly  aware  of  this 
than  those  who  have  graduated  at  this  institution. 
Here,  as  in  all  our  larger  city  schools,  the  greatest 
pains  are  taken  to  teach  things  as  well  as  name* 
You  have  entered  into  the  inheritance  of  a  vast  amount 


THE  YOUNG  PRACTITIONER.  375 

of  transmitted  skill  and  wisdom,  which  you  have  taken, 
warm,  as  it  were,  with  the  life  of  your  well-schooled  in 
structors.  You  have  not  learned  all  that  art  has  to  teach 
you,  but  you  are  safer  practitioners  to-day  than  were 
many  of  those  whose  names  we  hardly  mention  without 
a  genuflection.  I  had  rather  be  cared  for  in  a  fever  by 
the  best-taught  among  you  than  by  the  renowned  Ferne- 
lius  or  the  illustrious  Boerhaave,  could  they  come  back 
to  us  from  that  better  world  where  there  are  no  physi 
cians  needed,  and,  if  the  old  adage  can  be  trusted,  not 
many  within  call.  I  had  rather  have  one  of  you  exer 
cise  his  surgical  skill  upon  me  than  find  myself  in  the 
hands  of  a  resuscitated  Fabricius  Hildanus,  or  even  of 
a  wise  Ainbroise  Pare*,  revisiting  earth  in  the  light  of 
the  nineteenth  century. 

You  will  not  accuse  me  of  underrating  your  accom 
plishments.  You  know  what  to  do  for  a  child  in  a  fit, 
for  an  alderman  in  an  apoplexy,  for  a  girl  that  has 
fainted,  for  a  woman  in  hysterics,  for  a  leg  that  is 
broken,  for  an  arm  that  is  out  of  joint,  for  fevers  of 
every  color,  for  the  sailor's  rheumatism,  and  the  tail* 
or's  cachexy.  In  fact  you  do  really  know  so  much  at 
this  very  hour,  that  nothing  but  the  searching  test  of 
time  can  fully  teach  you  the  limitations  of  your  knowl- 


Of  some  of  these  you  will  permit  me  to  remind  you. 
You  will  never  have  outgrown  the  possibility  of  new 
acquisitions,  for  Nature  is  endless  in  her  variety.  But 
even  the  knowledge  which  you  may  be  said  to  possess 
will  be  a  different  thing  after  long  habit  has  made  it  a 
part  of  your  existence.  The  tactus  eruditus  extends 
to  the  mind  as  well  as  to  the  finger-ends.  Experience 
means  the  knowledge  gained  by  habitual  trial,  and  an 
expert  is  one  who  has  been  in  the  habit  of  trying.  This 


876  MEDICAL  ESSAYS. 

is  the  kind  of  knowledge  that  made  Ulysses  wise  in  the 
ways  of  men.  Many  cities  had  he  seen,  and  known 
the  minds  of  those  who  dwelt  in  them.  This  knowl 
edge  it  was  that  Chaucer's  Shipman  brought  home 
with  him  from  the  sea: 

"  In  many  a  tempest  had  his  herd  be  shake." 

This  is  the  knowledge  we  place  most  confidence  in,  in 
the  practical  affairs  of  life. 

Our  training  has  two  stages.  The  first  stage  deals 
with  our  intelligence,  which  takes  the  idea  of  what  is 
to  be  done  with  the  most  charming  ease  and  readiness. 
Let  it  be  a  game  of  billiards,  for  instance,  which  the 
marker  is  going  to  teach  us.  We  have  nothing  to  do 
but  to  make  this  ball  glance  from  that  ball  and  hit 
that  other  ball,  and  to  knock  that  ball  with  this  ball 
into  a  certain  caecal  sacculus  or  diverticulum  which 
our  professional  friend  calls  a  pocket.  Nothing  can 
be  clearer  ;  it  is  as  easy  as  "  playing  upon  this  pipe," 
for  which  Hamlet  gives  Guildenstern  such  lucid  direc 
tions.  But  this  intelligent  Me,  who  steps  forward  as 
the  senior  partner  in  our  dual  personality,  turns  out  to 
be  a  terrible  bungler.  He  misses  those  glancing  hits 
which  the  hard-featured  young  professional  person 
calls  "  carroms,"  and  insists  on  pocketing  his  own  ball 
instead  of  the  other  one. 

It  is  the  wwintelligent  Me,  stupid  as  an  idiot,  that 
has  to  try  a  thing  a  thousand  times  before  he  can  do 
it,  and  then  never  knows  how  he  does  it,  that  at  last 
does  it  well.  We  have  to  educate  ourselves  through 
the  pretentious  claims  of  intellect,  into  the  humble 
accuracy  of  instinct,  and  we  end  at  last  by  acquiring 
the  dexterity,  the  perfection,  the  certainty,  which  those 
masters  of  arts,  the  bee  and  the  spider,  inherit  from 
Nature. 


THE  YOUNG  PRACTITIONEE.  377 

Book-knowledge,  lecture-knowledge,  examination- 
knowledge,  are  all  in  the  brain.  But  work-knowledge 
is  not  only  in  the  brain,  it  is  in  the  senses,  in  the  mus 
cles,  in  the  ganglia  of  the  sympathetic  nerves,  —  all 
over  the  man,  as  one  may  say,  as  instinct  seems  dif 
fused  through  every  part  of  those  lower  animals  that 
have  no  such  distinct  organ  as  a  brain.  See  a  skilful 
surgeon  handle  a  broken  limb ;  see  a  wise  old  physi 
cian  smile  away  a  case  that  looks  to  a  novice  as  if  the 
sexton  would  soon  be  sent  for ;  mark  what  a  large 
experience  has  done  for  those  who  were  fitted  to  profit 
by  it,  and  you  will  feel  convinced  that,  much  as  you 
know,  something  is  still  left  for  you  to  learn. 

May  I  venture  to  contrast  youth  and  experience  in 
medical  practice,  something  in  the  way  the  man  painted 
the  lion,  that  is,  the  lion  under  ? 

The  young  man  knows  the  rules,  but  the  old  man 
knows  the  exceptions.  The  young  man  knows  his  pa 
tient,  but  the  old  man  knows  also  his  patient's  family, 
dead  and  alive,  up  and  down  for  generations.  He  can 
tell  beforehand  what  diseases  their  unborn  children 
will  be  subject  to,  what  they  will  die  of  if  they  live 
long  enough,  and  whether  they  had  better  live  at  all, 
or  remain  unrealized  possibilities,  as  belonging  to  a 
stock  not  worth  being  perpetuated.  The  young  man 
feels  uneasy  if  he  is  not  continually  doing  something 
to  stir  up  his  patient's  internal  arrangements.  The 
old  man  takes  things  more  quietly,  and  is  much  more 
willing  to  let  well  enough  alone.  All  these  superiori 
ties,  if  such  they  are,  you  must  wait  for  time  to  bring 
you.  In  the  meanwhile  (if  we  will  let  the  lion  be  up 
permost  for  a  moment),  the  young  man's  senses  are 
quicker  than  those  of  his  older  rival.  His  education 
in  all  the  accessory  branches  is  more  recent,  and  there- 


378  MEDICAL  ESSAYS. 

fore  nearer  the  existing  condition  of  knowledge.  He 
finds  it  easier  than  his  seniors  to  accept  the  improve 
ments  which  every  year  is  bringing  forward.  New  ideas 
build  their  nests  in  young  men's  brains.  "  Bevolutions 
are  not  made  by  men  in  spectacles,"  as  I  once  heard 
it  remarked,  and  the  first  whispers  of  a  new  truth  are 
not  caught  by  those  who  begin  to  feel  the  need  of  an 
ear-trumpet.  Granting  all  these  advantages  to  the 
young  man,  he  ought,  nevertheless,  to  go  on  improving, 
on  the  whole,  as  a  medical  practitioner,  with  every 
year,  until  he  has  ripened  into  a  well-mellowed  matu 
rity.  But,  to  improve,  he  must  be  good  for  something 
at  the  start.  If  you  ship  a  poor  cask  of  wine  to  India 
and  back,  if  you  keep  it  a  half  a  century,  it  only  grows 
thinner  and  sharper. 

You  are  soon  to  enter  into  relations  with  the  pub 
lic,  to  expend  your  skill  and  knowledge  for  its  benefit, 
and  find  your  support  in  the  rewards  of  your  labor. 
What  kind  of  a  constituency  is  this  which  is  to  look  to 
you  as  its  authorized  champions  in  the  struggle  of  life 
against  its  numerous  enemies  ? 

In  the  first  place,  the  persons  who  seek  the  aid  of 
the  physician  are  very  honest  and  sincere  in  their  wish 
to  get  rid  of  their  complaints,  and,  generally  speaking, 
to  live  as  long  as  they  can.  However  attractively  the 
future  is  painted  to  them,  they  are  attached  to  the 
planet  with  which  they  are  already  acquainted.  They 
are  addicted  to  the  daily  use  of  this  empirical  and  un- 
chemical  mixture  which  we  call  air,  and  would  hold  on 
to  it  as  a  tippler  does  to  his  alcoholic  drinks.  There 
is  nothing  men  will  not  do,  there  is  nothing  they  have 
not  done,  to  recover  their  health  and  save  their  lives. 
They  have  submitted  to  be  half-drowned  in  water,  and 
half-choked  with  gases,  to  be  buried  up  to  their  china 


THE  YOUNG  PEACTITIONER.  379 

in  earth,  to  be  seared  with  hot  irons  like  galley-slaves, 
to  be  crimped  with  knives,  like  cod-fish,  to  have  needles 
thrust  into  their  flesh,  and  bonfires  kindled  on  their 
skin,  to  swallow  all  sorts  of  abominations,  and  to  pay 
for  all  this,  as  if  to  be  singed  and  scalded  were  a  costly 
privilege,  as  if  blisters  were  a  blessing,  and  leeches 
were  a  luxury.  What  more  can  be  asked  to  prove  their 
honesty  and  sincerity  ? 

This  same  community  is  very  intelligent  with  respect 
to  a  great  many  subjects — commerce,  mechanics,  man 
ufactures,  politics.  But  with  regard  to  medicine  it  is 
hopelessly  ignorant  and  never  finds  it  out.  I  do  not 
know  that  it  is  any  worse  in  this  country  than  in  Great 
Britain,  where  Mr.  Huxley  speaks  very  freely  of  "  the 
utter  ignorance  of  the  simplest  laws  of  their  own  ani 
mal  life,  which  prevails  among  even  the  most  highly- 
educated  persons."  And  Cullen  said  before  him  : 
"  Neither  the  acutest  genius  nor  the  soundest  judgment 
will  avail  in  judging  of  a  particular  science,  in  regard 
to  which  they  have  not  been  exercised.  I  have  been 
obliged  to  please  my  patients  sometimes  with  reasons, 
and  I  have  found  that  any  will  pass,  even  with  able 
divines  and  acute  lawyers ;  the  same  will  pass  with  the 
husbands  as  with  the  wives."  If  the  community  could 
only  be  made  aware  of  its  own  utter  ignorance,  and  in 
competence  to  form  opinions  on  medical  subjects,  diffi 
cult  enough  to  those  who  give  their  lives  to  the  study 
of  them,  the  practitioner  would  have  an  easier  task. 
But  it  will  form  opinions  of  its  own,  it  cannot  help  it, 
and  we  cannot  blame  it,  even  though  we  know  how 
slight  and  deceptive  are  their  foundations. 

This  is  the  way  it  happens :  Every  grown-up  person 
has  either  been  ill  himself  or  had  a  friend  suffer  from 
illness,  from  which  he  has  recovered.  Every  sick  per- 


880  MEDICAL  ESSAYS. 

eon  has  done  something  or  other  by  somebody's  advice^ 
or  of  his  own  accord,  a  little  before  getting  better. 
There  is  an  irresistible  tendency  to  associate  the  thing 
done,  and  the  improvement  which  followed  it,  as  cause 
and  effect.  This  is  the  great  source  of  fallacy  in  med 
ical  practice.  But  the  physician  has  some  chance  of 
correcting  his  hasty  inference.  He  thinks  his  prescrip 
tion  cured  a  single  case  of  a  particular  complaint ;  he 
tries  it  in  twenty  similar  cases  without  effect,  and  sets 
down  the  first  as  probably  nothing  more  than  a  coin 
cidence.  The  unprofessional  experimenter  or  observer 
has  no  large  experience  to  correct  his  hasty  general 
ization.  He  wants  to  believe  that  the  means  he  em 
ployed  effected  his  cure.  He  feels  grateful  to  the 
person  who  advised  it,  he  loves  to  praise  the  pill  or 
potion  which  helped  him,  and  he  has  a  kind  of  monu 
mental  pride  in  himself  as  a  living  testimony  to  its 
efficacy.  So  it  is  that  you  will  find  the  community  in 
which  you  live,  be  it  in  town  or  country,  full  of  brands 
plucked  from  the  burning,  as  they  believe,  by  some 
agency  which,  with  your  better  training,  you  feel  rea 
sonably  confident  had  nothing  to  do  with  it.  Their 
disease  went  out  of  itself,  and  the  stream  from  the 
medical  fire-annihilator  had  never  even  touched  it. 

You  cannot  and  need  not  expect  to  disturb  the  pub 
lic  in  the  possession  of  its  medical  superstitions.  A 
man's  ignorance  is  as  much  his  private  property,  and 
as  precious  in  his  own  eyes,  as  his  family  Bible.  You 
have  only  to  open  your  own  Bible  at  the  ninth  chapter 
of  St.  John's  Gospel,  and  you  will  find  that  the  logic 
of  a  restored  patient  was  very  simple  then,  as  it  is  now, 
and  very  hard  to  deal  with.  My  clerical  friends  will 
forgive  me  for  poaching  on  their  sacred  territory,  in 
return  for  an  occasional  raid  upon  the  medical  domain 
of  which  they  have  now  and  then  been  accused. 


THE  YOUNG  PRACTITIONER.  381 

A  blind  man  was  said  to  have  been  restored  to  sight 
by  a  young  person  whom  the  learned  doctors  of  the 
Jewish  law  considered  a  sinner,  and,  as  such,  very  un 
likely  to  have  been  endowed  with  a  divine  gift  of  heal- 
%ng.  They  visited  the  patient  repeatedly,  and  evidently 
teased  him  with  their  questions  about  the  treatment, 
and  their  insinuations  about  the  young  man,  until  he 
lost  his  temper.  At  last  he  turned  sharply  upon  them : 
"  Whether  he  be  a  sinner  or  no,  I  know  not :  one  thing 
I  know,  that,  whereas  I  was  blind,  now  I  see." 

This  is  the  answer  that  always  has  been  and  always 
will  be  given  by  most  persons  when  they  find  them 
selves  getting  well  after  doing  anything,  no  matter 
what,  —  recommended  by  anybody,  no  matter  whom. 
Lord  Bacon,  Robert  Boyle,  Bishop  Berkeley,  all  put 
their  faith  in  panaceas  which  we  should  laugh  to  scorn. 
They  had  seen  people  get  well  after  using  them.  Are 
we  any  wiser  than  those  great  men  ?  Two  years  ago,  in 
a  lecture  before  the  Massachusetts  Historical  Society,  I 
mentioned  this  recipe  of  Sir  Kenelm  Digby  for  fever 
and  ague  :  Pare  the  patient's  nails ;  put  the  parings  in 
a  little  bag,  and  hang  the  bag  round  the  neck  of  a  live 
eel,  and  place  him  in  a  tub  of  water.  The  eeLwill  die, 
and  the  patient  will  recover. 

Referring  to  this  prescription  in  the  course  of  the 
same  lecture,  I  said :  "  You  smiled  when  I  related  Sir 
Kenelm  Digby's  prescription,  with  the  live  eel  in  it ; 
but  if  each  of  you  were  to  empty  his  or  her  pockets, 
would  there  not  roll  out,  from  more  than  one  of  them, 
a  horse-chestnut,  carried  about  as  a  cure  for  rheuma 
tism  ?  "  Nobody  saw  fit  to  empty  his  or  her  pockets, 
and  my  question  brought  no  response.  But  two  months 
jgo  I  was  in  a  company  of  educated  persons,  college 
graduates  every  one  of  them,  when  a  gentleman,  well 


882  MEDICAL  ESSAYS. 

known  in  our  community,  a  man  of  superior  ability  and 
strong  common-sense,  on  the  occasion  of  some  talk 
arising  about  rheumatism,  took  a  couple  of  very  shiny 
horse-chestnuts  from  his  breeches-pocket,  and  laid  them 
on  the  table,  telling  us  how,  having  suffered  from  the 
complaint  in  question,  he  had,  by  the  advice  of  a  friend, 
procured  these  two  horse-chestnuts  on  a  certain  time 
a  year  or  more  ago,  and  carried  them  about  him  ever 
since  ;  from  which  very  day  he  had  been  entirely  free 
from  rheumatism. 

This  argument,  from  what  looks  like  cause  and  effect, 
whether  it  be  so  or  not,  is  what  you  will  have  to  meet 
wherever  you  go,  and  you  need  not  think  you  can  an 
swer  it.  In  the  natural  course  of  things  some  thou 
sands  of  persons  must  be  getting  well  or  better  of 
slight  attacks  of  colds,  of  rheumatic  pains,  every  week, 
in  this  city  alone.  Hundreds  of  them  do  something 
or  other  in  the  way  of  remedy,  by  medical  or  other  ad 
vice,  or  of  their  own  motion,  and  the  last  thing  they 
do  gets  the  credit  of  the  recovery.  Think  what  a  crop 
of  remedies  this  must  furnish,  if  it  were  all  harvested  I 

Experience  has  taught,  or  will  teach  you,  that  most 
of  the  wonderful  stories  patients  and  others  tell  of  sud 
den  and  signal  cures  are  like  Owen  Glendower's  story 
of  the  portents  that  announced  his  birth.  The  earth 
shook  at  your  nativity,  did  it  ?  Very  likely,  and 

"  So  it  would  have  done, 
At  the  same  season,  if  your  mother's  cat 
Had  kittened,  though  yourself  had  ne'er  been  born." 

You  must  listen  more  meekly  than  Hotspur  did  to  the 
babbling  "Welshman,  for  ignorance  is  a  solemn  and 
sacred  fact,  and,  like  infancy,  which  it  resembles, 
should  be  respected.  Once  in  a  while  you  will  have  a 
patient  of  sense,  born  with  the  gift  of  observation, 


THE  TOTING  PRACTITIONER.  883 

from  whom  you  may  learn  something.  When  you  find 
yourself  in  the  presence  of  one  who  is  fertile  of  medi 
cal  opinions,  and  affluent  in  stories  of  marvellous 
cures,  —  of  a  member  of  Congress  whose  name  figures 
in  certificates  to  the  value  of  patent  medicines,  of  a 
voluble  dame  who  discourses  on  the  miracles  she  has 
wrought  or  seen  wrought  with  the  little  jokers  of  the 
sugar-of-milk  globule-box,  take  out  your  watch  and 
count  the  pulse  ;  also  note  the  time  of  day,  and  charge 
the  price  of  a  visit  for  every  extra  fifteen,  or,  if  you 
are  not  very  busy,  every  twenty  minutes.  In  this  way 
you  will  turn  what  seems  a  serious  dispensation  into  a 
double  blessing,  for  this  class  of  patients  loves  dearly 
to  talk,  and  it  does  them  a  deal  of  good,  and  you  feel 
as  if  you  had  earned  your  money  by  the  dose  you  have 
taken,  quite  as  honestly  as  by  any  dose  you  may  have 
ordered. 

You  must  take  the  community  just  as  it  is,  and  make 
the  best  of  it.  You  wish  to  obtain  its  confidence ;  there 
is  a  short  rule  for  doing  this  which  you  will  find  use 
ful,  —  deserve  it.  But,  to  deserve  it  in  full  measure, 
you  must  unite  many  excellences,  natural  and  acquired. 

As  the  basis  of  all  the  rest,  you  must  have  all  those 
traits  of  character  which  fit  you  to  enter  into  the  most 
intimate  and  confidential  relations  with  the  families  of 
which  you  are  the  privileged  friend  and  counsellor. 
Medical  Christianity,  if  I  may  use  such  a  term,  is  of 
very  early  date.  By  the  oath  of  Hippocrates,  the 
practitioner  of  ancient  times  bound  himself  to  enter 
his  patient's  house  with  the  sole  purpose  of  doing  him 
good,  and  so  to  conduct  himself  as  to  avoid  the  very 
appearance  of  evil.  Let  the  physician  of  to-day  begin 
by  coming  up  to  this  standard,  and  add  to  it  all  the 
more  recently  discovered  virtues  and  graces. 


384  MEDICAL  ESSAYS. 

A  certain  amount  of  natural  ability  is  requisite  to 
make  you  a  good  physician,  but  by  no  means  that  dis 
proportionate  development  of  some  special  faculty 
which  goes  by  the  name  of  genius.  A  just  balance  of 
the  mental  powers  is  a  great  deal  more  likely  to  be 
useful  than  any  single  talent,  even  were  it  the  power 
of  observation,  in  excess.  For  a  mere  observer  is  lia 
ble  to  be  too  fond  of  facts  for  their  own  sake,  so  that, 
if  he  told  the  real  truth,  he  would  confess  that  he 
takes  more  pleasure  in  a  post-mortem  examination 
which  shows  him  what  was  the  matter  with  a  patient, 
than  in  a  case  which  insists  on  getting  well  and  leav 
ing  him  in  the  dark  as  to  its  nature.  Far  more  likely 
to  interfere  with  the  sound  practical  balance  of  the 
mind  is  that  speculative,  theoretical  tendency  which 
has  made  so  many  men  noted  in  their  day,  whose  fame 
has  passed  away  with  their  dissolving  theories.  Read 
Dr.  Bartlett's  comparison  of  the  famous  Benjamin 
Rush  with  his  modest  fellow-townsman  Dr.  William 
Currie,  and  see  the  dangers  into  which  a  passion  for 
grandiose  generalizations  betrayed  a  man  of  many  ad 
mirable  qualities. 

I  warn  you  against  all  ambitious  aspirations  outside 
of  your  profession.  Medicine  is  the  most  difficult  of 
sciences  and  the  most  laborious  of  arts.  It  will  task 
all  your  powers  of  body  and  mind  if  you  are  faithful 
to  it.  Do  not  dabble  in  the  muddy  sewer  of  politics, 
nor  linger  by  the  enchanted  streams  of  literature,  nor 
dig  in  far-off  fields  for  the  hidden  waters  of  alien  sci 
ences.  The  great  practitioners  are  generally  those 
who  concentrate  all  their  powers  on  their  business.  If 
there  are  here  and  there  brilliant  exceptions,  it  is  only 
in  virtue  of  extraordinary  gifts,  and  industry  to  which 
very  few  are  equal. 


THE  YOUNG  PRACTITIONER.  385 

To  get  business  a  man  must  really  want  it ;  and  do 
you  suppose  that  when  you  are  in  the  middle  of  a 
heated  caucus,  or  half-way  through  a  delicate  analysis, 
or  in  the  spasm  of  an  unfinished  ode,  your  eyes  rolling 
in  the  fine  frenzy  of  poetical  composition,  you  want  to 
be  called  to  a  teething  infant,  or  an  ancient  person 
groaning  under  the  griefs  of  a  lumbago  ?  I  think  I 
have  known  more  than  one  young  man  whose  doctor's 
sign  proclaimed  his  readiness  to  serve  mankind  in  that 
capacity,  but  who  hated  the  sound  of  a  patient's 
knock,  and  as  he  sat  with  his  book  or  his  microscope, 
felt  exactly  as  the  old  party  expressed  himself  in  my 
friend  Mr.  Brownell's  poem  — 

"  All  I  axes  is,  let  me  alone." 

The  community  soon  finds  out  whether  you  are  in 
earnest,  and  really  mean  business,  or  whether  you  are 
one  of  those  diplomaed  dilettanti  who  like  the  amuse 
ment  of  quasi  medical  studies,  but  have  no  idea  of 
wasting  their  precious  time  in  putting  their  knowledge 
in  practice  for  the  benefit  of  their  suffering  fellow- 
creatures. 

The  public  is  a  very  incompetent  judge  of  your  skill 
and  knowledge,  but  it  gives  its  confidence  most  readily 
to  those  who  stand  well  with  their  professional  breth 
ren,  whom  they  call  upon  when  they  themselves  or 
their  families  are  sick,  whom  they  choose  to  honorable 
offices,  whose  writings  and  teachings  they  hold  in  es 
teem.  A  man  may  be  much  valued  by  the  profession 
and  yet  have  defects  which  prevent  his  becoming  a 
favorite  practitioner,  but  no  popularity  can  be  de 
pended  upon  as  permanent  which  is  not  sanctioned  by 
the  judgment  of  professional  experts,  and  with  these 
you  will  always  stand  on  your  substantial  merits. 


886  MEDICAL  ESSAYS. 

What  shall  I  say  of  the  personal  habits  you  must 
form  if  you  wish  for  success?  Temperance  is  first 
upon  the  list.  Intemperance  in  a  physician  partakes 
of  the  guilt  of  homicide,  for  the  muddled  brain  may 
easily  make  a  fatal  blunder  in  a  prescription  and  the 
unsteady  hand  transfix  an  artery  in  an  operation.  Tip 
pling  doctors  have  been  too  common  in  the  history  of 
medicine.  Paracelsus  was  a  sot,  Radcliffe  was  much 
too  fond  of  his  glass,  and  Dr.  James  Hurlbut  of 
Wethersfield,  Connecticut,  a  famous  man  in  his  time, 
used  to  drink  a  square  bottle  of  rum  a  day,  with  a  corre 
sponding  allowance  of  opium  to  help  steady  his  nerves. 
We  commonly  speak  of  a  man  as  being  the  worse  for 
liquor,  but  I  was  asking  an  Irish  laborer  one  day 
about  his  doctor,  who,  as  he  said,  was  somewhat  given 
to  drink.  "  I  like  him  best  when  he  's  a  little  that 
way,"  he  said ;  "  then  I  can  spake  to  him."  I  pitied 
the  poor  patient  who  could  not  venture  to  allude  to  his 
colic  or  his  pleurisy  until  his  physician  was  tipsy. 

There  are  personal  habits  of  less  gravity  than  the 
one  I  have  mentioned  which  it  is  well  to  guard  against, 
or,  if  they  are  formed,  to  relinquish.  A  man  who  may 
be  called  at  a  moment's  warning  into  the  fragrant  bou 
doir  of  suffering  loveliness  should  not  unsweeteu  its 
atmosphere  with  reminiscences  of  extinguished  meer 
schaums.  He  should  remember  that  the  sick  are  sen 
sitive  and  fastidious,  that  they  love  the  sweet  odors 
and  the  pure  tints  of  flowers,  and  if  his  presence  is  not 
like  the  breath  of  the  rose,  if  his  hands  are  not  like 
the  leaf  of  the  lily,  his  visit  may  be  unwelcome,  and  if 
he  looks  behind  him  he  may  see  a  window  thrown  open 
after  he  has  left  the  sick-chamber.  I  remember  too 
well  the  old  doctor  who  sometimes  came  to  help  me 
through  those  inward  griefs  to  which  childhood  is  lia- 


THE  YOUNG  PRACTITIONER.  887 

ble.  "  Far  off  his  coming  "  —  shall  I  say  "  shone," 
and  finish  the  Miltonic  phrase,  or  leave  the  verb  to  the 
happy  conjectures  of  my  audience  ?  Before  him  came 
a  soul-subduing  whiff  of  ipecacuanha,  and  after  him 
lingered  a  shuddering  consciousness  of  rhubarb.  He 
had  lived  so  much  among  his  medicaments  that  he  had 
at  last  become  himself  a  drug,  and  to  have  him  pass 
through  a  sick-chamber  was  a  stronger  dose  than  a 
conscientious  disciple  of  Hahnemann  would  think  it 
safe  to  administer. 

Need  I  remind  you  of  the  importance  of  punctuality 
in  your  engagements,  and  of  the  worry  and  distress  to 
patients  and  their  friends  which  the  want  of  it  occa 
sions?  One  of  my  old  teachers  always  carried  two 
watches,  to  make  quite  sure  of  being  exact,  and  not 
only  kept  his  appointments  with  the  regularity  of  a 
chronometer,  but  took  great  pains  to  be  at  his  patient's 
house  at  the  time  when  he  had  reason  to  believe  he 
was  expected,  even  if  no  express  appointment  was 
made.  It  is  a  good  rule ;  if  you  call  too  early,  my 
lady's  hair  may  not  be  so  smooth  as  could  be  wished, 
and,  if  you  keep  her  waiting  too  long,  her  hair  may  be 
smooth,  but  her  temper  otherwise. 

You  will  remember,  of  course,  always  to  get  the 
weather-gage  of  your  patient.  I  mean,  to  place  him 
so  that  the  light  falls  on  his  face  and  not  on  yours.  It 
is  a  kind  of  ocular  duel  that  is  about  to  take  place  be 
tween  you  ;  you  are  going  to  look  through  his  features 
into  his  pulmonary  and  hepatic  and  other  internal  ma 
chinery,  and  he  is  going  to  look  into  yours  quite  as 
sharply  to  see  what  you  think  about  his  probabilities 
for  time  or  eternity. 

No  matter  how  hard  he  stares  at  your  countenance, 
be  should  never  be  able  to  read  his  fate  in  it.  It 


888  MEDICAL   ESSAYS. 

should  be  cheerful  as  long  as  there  is  hope,  and  serene 
in  its  gravity  when  nothing  is  left  but  resignation. 
The  face  of  a  physician,  like  that  of  a  diplomatist, 
should  be  impenetrable.  Nature  is  a  benevolent  old 
hypocrite  ;  she  cheats  the  sick  and  the  dying  with  illu 
sions  better  than  any  anodynes.  If  there  are  cogent 
reasons  why  a  patient  should  be  undeceived,  do  it  de 
liberately  and  advisedly,  but  do  not  betray  your  appre 
hensions  through  your  tell-tale  features. 

We  had  a  physician  in  our  city  whose  smile  was 
commonly  reckoned  as  being  worth  five  thousand  dol 
lars  a  year  to  him,  in  the  days,  too,  of  moderate  in 
comes.  You  cannot  put  on  such  a  smile  as  that  any 
more  than  you  can  get  sunshine  without  sun ;  there 
was  a  tranquil  and  kindly  nature  under  it  ihat  irradi 
ated  the  pleasant  face  it  made  one  happier  to  meet  on 
his  daily  rounds.  But  you  can  cultivate  the  disposi 
tion,  and  it  will  work  its  way  through  to  the  surface,  — 
nay,  more,  —  you  can  try  to  wear  a  quiet  and  encour 
aging  look,  and  it  will  react  on  your  disposition  and 
make  you  like  what  you  seem  to  be,  or  at  least  bring 
you  nearer  to  its  own  likeness. 

Your  patient  has  no  more  right  to  all  the  truth  you 
know  than  he  has  to  all  the  medicine  in  your  saddle 
bags,  if  you  carry  that  kind  of  cartridge-box  for  the 
ammunition  that  slays  disease.  He  should  get  only 
just  so  much  as  is  good  for  him.  I  have  seen  a  physi 
cian  examining  a  patient's  chest  stop  all  at  once,  as  he 
brought  out  a  particular  sound  with  a  tap  on  the  col 
lar-bone,  in  the  attitude  of  a  pointer  who  has  just  come 
on  the  scent  or  sight  of  a  woodcock.  You  remember 
the  Spartan  boy,  who,  with  unmoved  countenance,  hid 
the  fox  that  was  tearing  his  vitals  beneath  his  mantle. 
What  he  could  do  in  his  own  suffering  you  must  learn 


THE  YOUNG  PRACTITIONER.  389 

to  do  for  others  on  whose  vital  organs  disease  has  fast 
ened  its  devouring  teeth.  It  is  a  terrible  thing  to  take 
away  hope,  even  earthly  hope,  from  a  fellow-creature. 
Be  very  careful  what  names  you  let  fall  before  your 
patient.  He  knows  what  it  means  when  you  tell  him 
he  has  tubercles  or  Bright's  disease,  and,  if  he  hears 
the  word  carcinoma,  he  will  certainly  look  it  out  in  a 
medical  dictionary,  if  he  does  not  interpret  its  dread 
significance  on  the  instant.  Tell  him  he  has  asthmatic 
symptoms,  or  a  tendency  to  the  gouty  diathesis,  and 
he  will  at  once  think  of  all  the  asthmatic  and  gouty 
old  patriarchs  he  has  ever  heard  of,  and  be  comforted. 
You  need  not  be  so  cautious  in  speaking  of  the  health 
of  rich  and  remote  relatives,  if  he  is  in  the  line  of  suc 
cession. 

Some  shrewd  old  doctors  have  a  few  phrases  always 
on  hand  for  patients  that  will  insist  on  knowing  the 
pathology  of  their  complaints  without  the  slightest  ca 
pacity  of  understanding  the  scientific  explanation.  I 
have  known  the  term  "  spinal  irritation  "  serve  well 
on  such  occasions,  but  I  think  nothing  on  the  whole 
has  covered  so  much  ground,  and  meant  so  little,  and 
given  such  profound  satisfaction  to  all  parties,  as  the 
magnificent  phrase  "  congestion  of  the  portal  system." 

Once  more,  let  me  recommend  you,  as  far  as  possi 
ble,  to  keep  your  doubts  to  yourself,  and  give  the  pa 
tient  the  benefit  of  your  decision.  Firmness,  gentle 
firmness,  is  absolutely  necessary  in  this  and  certain 
other  relations.  Mr.  Rarey  with  Cruiser,  Richard  with 
Lady  Ann,  Pinel  with  his  crazy  people,  show  what 
steady  nerves  can  do  with  the  most  intractable  of  ani 
mals,  the  most  irresistible  of  despots,  and  the  most  un 
manageable  of  invalids. 

If  you  cannot  acquire  and  keep  the  confidence  of 


890  MEDICAL   ESSAYS. 

your  patient,  it  is  time  for  you  to  give  place  to  some 
other  practitioner  who  can.  If  you  are  wise  and  dili 
gent,  you  can  establish  relations  with  the  best  of  them 
which  they  will  find  it  very  hard  to  break.  But,  if 
they  wish  to  employ  another  person,  who,  as  they 
think,  knows  more  than  you  do,  do  not  take  it  as  a 
personal  wrong.  A  patient  believes  another  man  can 
save  his  life,  can  restore  him  to  health,  which,  as  he 
thinks,  you  have  not  the  skill  to  do.  No  matter 
whether  the  patient  is  right  or  wrong,  it  is  a  great  im 
pertinence  to  think  you  have  any  property  in  him. 
Your  estimate  of  your  own  ability  is  not  the  question, 
it  is  what  the  patient  thinks  of  it.  All  your  wisdom 
is  to  him  like  the  lady's  virtue  in  Raleigh's  song :  — 

"  If  she  seem  not  chaste  to  me, 
What  care  I  how  chaste  she  be  ?  " 

What  I  call  a  good  patient  is  one  who,  having  found 
a  good  physician,  sticks  to  him  till  he  dies.  But  there 
are  many  very  good  people  who  are  not  what  I  call 
good  patients.  I  was  once  requested  to  call  on  a  lady 
suffering  from  nervous  and  other  symptoms.  It  came 
out  in  the  preliminary  conversational  skirmish,  half 
medical,  half  social,  that  I  was  the  twenty-sixth  mem 
ber  of  the  faculty  into  whose  arms,  professionally 
speaking,  she  had  successively  thrown  herself.  Not 
being  a  believer  in  such  a  rapid  rotation  of  scientific 
crops,  I  gently  deposited  the  burden,  commending  it 
to  the  care  of  number  twenty-seven,  and,  him,  whoever 
he  might  be,  to  the  care  of  Heaven. 

If  there  happened  to  be  among  my  audience  any 
person  who  wished  to  know  on  what  principles  the  pa 
tient  should  choose  his  physician,  I  should  give 
these  few  precepts  to  think  over  :  — 


THE  YOUNG  PRACTITIONER.  391 

Choose  a  man  who  is  personally  agreeable,  for  a 
daily  visit  from  an  intelligent,  amiable,  pleasant,  sym 
pathetic  person  will  cost  you  no  more  than  one  from  a 
sloven  or  a  boor,  and  his  presence  will  do  more  for 
you  than  any  prescription  the  other  will  order. 

Let  him  be  a  man  of  recognized  good  sense  in  other 
matters,  and  the  chance  is  that  he  will  be  sensible  as 
a  practitioner. 

Let  him  be  a  man  who  stands  well  with  his  profes 
sional  brethren,  whom  they  approve  as  honest,  able, 
courteous. 

Let  him  be  one  whose  patients  are  willing  to  die  in 
his  hands,  not  one  whom  they  go  to  for  trifles,  and 
leave  as  soon  as  they  are  in  danger,  and  who  can  say, 
therefore,  that  he  never  loses  a  patient. 

Do  not  leave  the  ranks  of  what  is  called  the  regu 
lar  profession,  unless  you  wish  to  go  farther  and  fare 
worse,  for  you  may  be  assured  that  its  members  recog 
nize  no  principle  which  hinders  their  accepting  any 
remedial  agent  proved  to  be  useful,  no  matter  from 
what  quarter  it  comes.  The  difficulty  is  that  the 
stragglers,  organized  under  fantastic  names  in  preten 
tious  associations,  or  lurking  in  solitary  dens  behind 
doors  left  ajar,  make  no  real  contributions  to  the  art 
of  healing.  When  they  bring  forward  a  remedial 
agent  like  chloral,  like  the  bromide  of  potassium,  like 
ether,  used  as  an  anaesthetic,  they  will  find  no  diffi 
culty  in  procuring  its  recognition. 

Some  of  you  will  probably  be  more  or  less  troubled 
by  the  pretensions  of  that  parody  of  mediaeval  theol 
ogy  which  finds  its  dogma  of  hereditary  depravity  in 
the  doctrine  of  psora,  its  miracle  of  transubstantiation 
in  the  mystery  of  its  triturations  and  dilutions,  its 
church  in  the  people  who  have  mistaken  their  century, 


MEDICAL  ESSAYS. 

and  its  priests  in  those  who  have  mistaken  their  call 
ing.  You  can  do  little  with  persons  who  are  disposed 
to  accept  these  curious  medical  superstitions.  The 
saturation-point  of  individual  minds  with  reference  to 
evidence,  and  especially  medical  evidence,  differs,  and 
must  always  continue  to  differ,  very  widely.  There 
are  those  whose  minds  are  satisfied  with  the  decillionth 
dilution  of  a  scientific  proof.  No  wonder  they  believe 
in  the  efficacy  of  a  similar  attenuation  of  bryony  or 
pulsatilla.  You  have  no  fulcrum  you  can  rest  upon 
to  lift  an  error  out  of  such  minds  as  these,  often 
highly  endowed  with  knowledge  and  talent,  sometimes 
with  genius,  but  commonly  richer  in  the  imaginative 
than  the  observing  and  reasoning  faculties. 

Let  me  return  once  more  to  the  young  graduate. 
Your  relations  to  your  professional  brethren  may  be  a 
source  of  lifelong  happiness  and  growth  in  knowledge 
and  character,  or  they  may  make  you  wretched  and 
end  by  leaving  you  isolated  from  those  who  should  be 
your  friends  and  counsellors.  The  life  of  a  physician 
becomes  ignoble  when  he  suffers  himself  to  feed  on 
petty  jealousies  and  sours  his  temper  in  perpetual 
quarrels.  You  will  be  liable  to  meet  an  uncomforta 
ble  man  here  and  there  in  the  profession,  —  one  who  is 
so  fond  of  being  in  hot  water  that  it  is  a  wonder  all 
the  albumen  in  his  body  is  not  coagulated.  There  are 
common  barrators  among  doctors  as  there  are  among 
lawyers,  —  stirrers  up  of  strife  under  one  pretext  and 
another,  but  in  reality  because  they  like  it.  They  are 
their  own  worst  enemies,  and  do  themselves  a  mischief 
each  time  they  assail  their  neighbors.  In  my  student- 
days  I  remember  a  good  deal  of  this  Donnybrook-Fair 
style  of  quarrelling,  more  especially  in  Paris,  where 
Borne  of  the  noted  surgeons  were  always  at  logger- 


THE   YOUNG   PRACTITIONER.  393 

heads,  and  in  one  of  our  lively  "Western  cities.  Soon 
after  I  had  set  up  an  office,  I  had  a  trifling  experience 
which  may  serve  to  point  a  moral  in  this  direction.  I 
had  placed  a  lamp  behind  the  glass  in  the  entry  to  in 
dicate  to  the  passer-by  where  relief  from  all  curable 
infirmities  was  to  be  sought  and  found.  Its  brilliancy 
attracted  the  attention  of  a  devious  youth,  who  dashed 
his  fist  through  the  glass  and  upset  my  modest  lumi 
nary.  All  he  got  by  his  vivacious  assault  was  that  he 
left  portions  of  integument  from  his  knuckles  upon 
the  glass,  had  a  lame  hand,  was  very  easily  identified, 
and  had  to  pay  the  glazier's  bill.  The  moral  is  that, 
if  the  brilliancy  of  another's  reputation  excites  your 
belligerent  instincts,  it  is  not  worth  your  while  to 
strike  at  it,  without  calculating  which  of  you  is  likely 
to  suffer  most,  if  you  do. 

You  may  be  assured  that  when  an  ill-conditioned 
neighbor  is  always  complaining  of  a  bad  taste  in  his 
mouth  and  an  evil  atmosphere  about  him,  there  is 
something  wrong  about  his  own  secretions.  In  such 
cases  there  is  an  alterative  regimen  of  remarkable  effi 
cacy  :  it  is  a  starvation-diet  of  letting  alone.  The  great 
majority  of  the  profession  are  peacefully  inclined. 
Their  pursuits  are  eminently  humanizing,  and  they 
look  with  disgust  on  the  personalities  which  intrude 
themselves  into  the  placid  domain  of  an  art  whose 
province  it  is  to  heal  and  not  to  wound. 

The  intercourse  of  teacher  and  student  in  a  large 
school  is  necessarily  limited,  but  it  should  be,  and,  so 
far  as  my  experience  goes,  it  is,  eminently  cordial  and 
kindly.  You  will  leave  with  regret,  and  hold  in  tender 
remembrance,  those  who  have  taken  you  by  the  hand 
at  your  entrance  on  your  chosen  path,  and  led  you 
patiently  and  faithfully,  until  the  great  gates  at  its  end 


894  MEDICAL  ESSAYS. 

have  swung  upon  their  hinges,  and  the  world  lies  open 
before  you.  That  venerable  oath  to  which  I  have  be 
fore  referred  bound  the  student  to  regard  his  instructor 
in  the  light  of  a  parent,  to  treat  his  children  like  broth 
ers,  to  succor  him  in  his  day  of  need.  I  trust  the 
spirit  of  the  oath  of  Hippocrates  is  not  dead  in  the 
hearts  of  the  students  of  to-day.  They  will  remember 
with  gratitude  every  earnest  effort,  every  encouraging 
word,  which  has  helped  them  in  their  difficult  and  la 
borious  career  of  study.  The  names  they  read  on 
their  diplomas  will  recall  faces  that  are  like  family- 
portraits  in  their  memory,  and  the  echo  of  voices  they 
have  listened  to  so  long  will  linger  in  their  memories 
far  into  the  still  evening  of  their  lives. 

One  voice  will  be  heard  no  more  which  has  been 
familiar  to  many  among  you.  It  is  not  for  me,  a 
stranger  to  these  scenes,  to  speak  his  eulogy.  I  have 
no  right  to  sadden  this  hour  by  dwelling  on  the  deep 
regrets  of  friendship,  or  to  bid  the  bitter  tears  of  sor 
row  flow  afresh.  Yet  I  cannot  help  remembering  what 
a  void  the  death  of  such  a  practitioner  as  your  late  in 
structor  must  leave  in  the  wide  circle  of  those  who 
leaned  upon  his  counsel  and  assistance  in  their  hour  of 
need,  in  a  community  where  he  was  so  widely  known 
and  esteemed,  in  a  school  where  he  bore  so  important 
a  part.  There  is  no  exemption  from  the  common  doom 
for  him  who  holds  the  shield  to  protect  others.  The 
student  is  called  from  his  bench,  the  professor  from 
his  chair,  the  practitioner  in  his  busiest  period  hears  a 
knock  more  peremptory  than  any  patient's  midnight 
summons,  and  goes  on  that  unreturning  visit  which  ad 
mits  of  no  excuse,  and  suffers  no  delay.  The  call  of 
such  a  man  away  from  us  is  the  bereavement  of  a  great 
family.  Nor  can  we  help  regretting  the  loss  for  him 


THE  YOUNG  PRACTITIONER.  395 

of  a  bright  and  cheerful  earthly  future ;  for  the  old 
age  of  a  physician  is  one  of  the  happiest  periods  of  his 
life.  He  is  loved  and  cherished  for  what  he  has  been, 
and  even  in  the  decline  of  his  faculties  there  are  oc 
casions  when  his  experience  is  still  appealed  to,  and  his 
trembling  hands  are  looked  to  with  renewing  hope  and 
trust,  as  being  yet  able  to  stay  the  arm  of  the  destroyer. 

But  if  there  is  so  much  left  for  age,  how  beautiful, 
how  inspiring  is  the  hope  of  youth !  I  see  among  those 
whom  I  count  as  listeners  one  by  whose  side  I  have 
sat  as  a  fellow-teacher,  and  by  whose  instructions  I 
have  felt  myself  not  too  old  to  profit.  As  we  borrowed 
him  from  your  city,  I  must  take  this  opportunity  of 
telling  you  that  his  zeal,  intelligence,  and  admirable 
faculty  as  an  instructor  were  heartily  and  universally 
recognized  among  us.  We  return  him,  as  we  trust,  un 
injured,  to  the  fellow-citizens  who  have  the  privilege  of 
claiming  him  as  their  own. 

And  now,  gentlemen  of  the  graduating  class,  nothing 
remains  but  for  me  to  bid  you,  in  the  name  of  those  for 
whom  I  am  commissioned  and  privileged  to  speak,  fare 
well  as  students,  and  welcome  as  practitioners.  I  pro 
nounce  the  two  benedictions  in  the  same  breath,  as  the 
late  king's  demise  and  the  new  king's  accession  are  pro 
claimed  by  the  same  voice  at  the  same  moment.  You 
would  hardly  excuse  me  if  I  stooped  to  any  meaner 
dialect  than  the  classical  and  familiar  language  of  your 
prescriptions,  the  same  in  which  your  title  to  the  name 
of  physician  is,  if,  like  our  own  institution,  you  follow 
the  ancient  usage,  engraved  upon  your  diplomas. 

Valete,  JUVENES,  artis  medicce  studiosi;  valete, 
discipuli,  valete,  filil  I 

Salvete,  VIRI,  artis  medicce  magistri  ;  salvete,  am 
id  ;  salvete^fratrest 


VIII. 
MEDICAL  LIBRARIES.' 

IT  is  my  appointed  task,  my  honorable  privilege, 
this  evening,  to  speak  of  what  has  been  done  by  others. 
No  one  can  bring  his  tribute  of  words  into  the  pres 
ence  of  great  deeds,  or  try  with  them  to  embellish  the 
memory  of  any  inspiring  achievement,  without  feeling 
and  leaving  with  others  a  sense  of  their  insufficiency. 
So  felt  Alexander  when  he  compared  even  his  adored 
Homer  with  the  hero  the  poet  had  sung.  So  felt 
Webster  when  he  contrasted  the  phrases  of  rhetoric 
with  the  eloquence  of  patriotism  and  of  self-devotion. 
So  felt  Lincoln  when  on  the  field  of  Gettysburg  he 
spoke  those  immortal  words  which  Pericles  could  not 
have  bettered,  which  Aristotle  could  not  have  criticised. 
So  felt  he  who  wrote  the  epitaph  of  the  builder  of  the 
dome  which  looks  down  on  the  crosses  and  weather 
cocks  that  glitter  over  London. 

We  are  not  met  upon  a  battle-field,  except  so  far  as 
every  laborious  achievement  means  a  victory  over  op 
position,  indifference,  selfishness,  faintheartedness,  and 
that  great  property  of  mind  as  well  as  matter,  —  inertia. 
We  are  not  met  in  a  cathedral,  except  so  far  as  every 
building  whose  walls  are  lined  with  the  products  of  use 
ful  and  ennobling  thought  is  a  temple  of  the  Almighty, 
whose  inspiration  has  given  us  understanding.  But 

•  Dedicatory  Address  at  the  opening  of  the  Medical  Library 
in  Boston,  December  3,  1878. 


MEDICAL  LIBRARIES.  397 

we  have  gathered  within  walls  which  bear  testimony 
to  the  self-sacrificing,  persevering  efforts  of  a  few 
young  men,  to  whom  we  owe  the  origin  and  develop 
ment  of  all  that  excites  our  admiration  in  this  com 
pleted  enterprise;  and  I  might  consider  my  task  as 
finished  if  I  contented  myself  with  borrowing  the  last 
word  of  the  architect's  epitaph  and  only  saying,  Look 
around  you ! 

The  reports  of  the  librarian  have  told  or  will  tell 
you,  in  some  detail,  what  has  been  accomplished  since 
the  21st  of  December,  1874,  when  six  gentlemen  met 
at  the  house  of  Dr.  Henry  Ingersoll  Bowditch  to  dis 
cuss  different  projects  for  a  medical  library.  In  less 
than  four  years  from  that  time,  by  the  liberality  of  as 
sociations  and  of  individuals,  this  collection  of  nearly 
ten  thousand  volumes,  of  five  thousand  pamphlets,  and 
of  one  hundred  and  twenty-five  journals,  regularly  re 
ceived,  —  all  worthily  sheltered  beneath  this  lofty  roof, 
—  has  come  into  being  under  our  eyes.  It  has  sprung 
up,  as  it  were,  in  the  night  like  a  mushroom ;  it  stand? 
before  us  in  full  daylight  as  lusty  as  an  oak,  and  prom 
ising  to  grow  and  flourish  in  the  perennial  freshness  of 
an  evergreen. 

To  whom  does  our  profession  owe  this  already  large 
collection  of  books,  exceeded  in  numbers  only  by  four 
or  five  of  the  most  extensive  medical  libraries  in  the 
country,  and  lodged  in  a  building  so  well  adapted  to 
its  present  needs  ?  We  will  not  point  out  individually 
all  those  younger  members  of  the  profession  who  have 
accomplished  what  their  fathers  and  elder  brethren  had 
attempted  and  partially  achieved.  We  need  not  write 
their  names  on  these  walls,  after  the  fashion  of  those 
eivic  dignitaries  who  immortalize  themselves  on  tablets 
of  marble  and  gates  of  iron.  But  their  coiitempora/ 


398  MEDICAL  ESSAYS. 

ries  know  them  well,  and  their  descendants  will  not 
forget  them,  —  the  men  who  first  met  together,  the  men 
who  have  given  their  time  and  their  money,  the  faith 
ful  workers,  worthy  associates  of  the  strenuous  agitator 
who  gave  no  sleep  to  his  eyes,  no  slumber  to  his  eye 
lids,  until  he  had  gained  his  ends ;  the  untiring,  im 
perturbable,  tenacious,  irrepressible,  all-subduing  agi 
tator  who  neither  rested  nor  let  others  rest  until  the 
success  of  the  project  was  assured.  If,  against  his 
injunctions,  I  name  Dr.  James  Read  Chadwick,  it  is 
only  my  revenge  for  his  having  kept  me  awake  so  often 
and  so  long  while  he  was  urging  on  the  undertaking 
in  which  he  has  been  preeminently  active  and  trium 
phantly  successful. 

We  must  not  forget  the  various  medical  libraries 
which  preceded  this :  that  of  an  earlier  period,  when 
Boston  contained  about  seventy  regular  practitioners, 
the  collection  afterwards  transferred  to  the  Boston 
Athenaeum ;  the  two  collections  belonging  to  the  Uni 
versity  ;  the  Treadwell  Library  at  the  Massachusetts 
General  Hospital ;  the  collections  of  the  two  societies, 
that  for  Medical  Improvement  and  that  for  Medical 
Observation;  and  more  especially  the  ten  thousand 
volumes  relating  to  medicine  belonging  to  our  noble 
public  city  library,  —  too  many  blossoms  on  the  tree  of 
knowledge,  perhaps,  for  the  best  fruit  to  ripen.  But 
the  Massachusetts  Medical  Society  now  numbers  nearly 
four  hundred  members  in  the  city  of  Boston.  The 
time  had  arrived  for  a  new  and  larger  movement. 
There  was  needed  a  place  to  which  every  respectable 
member  of  the  medical  profession  could  obtain  easy 
access ;  where,  under  one  roof,  all  might  find  the  spe 
cial  information  they  were  seeking ;  where  the  latest 
medical  intelligence  should  be  spread  out  daily  as  the 


MEDICAL  LIBRARIES.  399 

shipping  news  is  posted  on  the  bulletins  of  the  ex 
change  ;  where  men  engaged  in  a  common  pursuit 
could  meet,  surrounded  by  the  mute  oracles  of  science 
and  art ;  where  the  whole  atmosphere  should  be  as  full 
of  professional  knowledge  as  the  apothecary's  shop  is 
of  the  odor  of  his  medicaments.  This  was  what  the 
old  men  longed  for,  —  the  prophets  and  kings  of  the 

profession,  who 

"Desired  it  long, 
But  died  without  the  sight.'* 

This  is  what  the  young  men  and  those  who  worked 
under  their  guidance  undertook  to  give  us.  And  now 
such  a  library,  such  a  reading-room,  such  an  exchange, 
such  an  intellectual  and  social  meeting-place,  we  be 
hold  a  fact,  plain  before  us.  The  medical  profession 
of  our  city,  and,  let  us  add,  of  all  those  neighboring 
places  which  it  can  reach  with  its  iron  arms,  is  united 
as  never  before  by  the  commune  vinculum,  the  com 
mon  bond  of  a  large,  enduring,  ennobling,  unselfish 
interest.  It  breathes  a  new  air  of  awakened  intel 
ligence.  It  marches  abreast  of  the  other  learned 
professions,  which  have  long  had  their  extensive  and 
valuable  centralized  libraries ;  abreast  of  them,  but  not 
promising  to  be  content  with  that  position.  What 
glorifies  a  town  like  a  cathedral  ?  What  dignifies  a 
province  like  a  university?  What  illuminates  a  coun 
try  like  its  scholarship,  and  what  is  the  nest  that 
hatches  scholars  but  a  library? 

The  physician,  some  may  say,  is  a  practical  man 
and  has  little  use  for  all  this  book-learning.  Every 
student  has  heard  Sydenham's  reply  to  Sir  Richard 
Blackmore's  question  as  to  what  books  he  should  read, 
—  meaning  medical  books.  "Read  Don  Quixote," 
was  his  famous  answer.  But  Sydenham  himself  made 


400  MEDICAL  ESSAYS. 

medical  books  and  may  be  presumed  to  have  thought 
those  at  least  worth  reading.  Descartes  was  asked 
where  was  his  library,  and  in  reply  held  up  the  dis 
sected  body  of  an  animal.  But  Descartes  made  books, 
great  books,  and  a  great  many  of  them.  A  physician 
of  common  sense  without  erudition  is  better  than  a 
learned  one  without  common  sense,  but  the  thorough 
master  of  his  profession  must  have  learning  added  to 
his  natural  gifts. 

It  is  not  necessary  to  maintain  the  direct  practical 
utility  of  all  kinds  of  learning.  Our  shelves  contain 
many  books  which  only  a  certain  class  of  medical 
scholars  will  be  likely  to  consult.  There  is  a  dead 
medical  literature,  and  there  is  a  live  one.  The  dead 
is  not  all  ancient,  the  live  is  not  all  modern.  There  is 
none,  modern  or  ancient,  which,  if  it  has  no  living 
value  for  the  student,  will  not  teach  him  something  by 
its  autopsy.  But  it  is  with  the  live  literature  of  his 
profession  that  the  medical  practitioner  is  first  of  all 
concerned. 

Now  there  has  come  a  great  change  in  our  time  over 
the  form  in  which  living  thought  presents  itself.  The 
first  printed  books,  —  the  incunabula, — were  inclosed 
in  boards  of  solid  oak,  with  brazen  clasps  and  corners ; 
the  boards  by  and  by  were  replaced  by  pasteboard  cov 
ered  with  calf  or  sheepskin ;  then  cloth  came  in  and 
took  the  place  of  leather ;  then  the  pasteboard  was 
covered  with  paper  instead  of  cloth ;  and  at  this  day 
the  quarterly,  the  monthly,  the  weekly  periodical  in 
its  flimsy  unsupported  dress  of  paper,  and  the  daily 
journal,  naked  as  it  came  from  the  womb  of  the  press, 
hold  the  larger  part  of  the  fresh  reading  we  live  upon. 
We  must  have  the  latest  thought  in  its  latest  expres 
sion  ;  the  page  must  be  newly  turned  like  the  morning 


MEDICAL  LIBRARIES.  401 

bannock ;  the  pamphlet  must  be  newly  opened  like  the 
ante-prandial  oyster. 

Thus  a  library,  to  meet  the  need  of  our  time,  must 
take,  and  must  spread  out  in  a  convenient  form,  a  great 
array  of  periodicals.  Our  active  practitioners  read 
these  by  preference  over  almost  everything  else.  Our 
specialists,  more  particularly,  depend  on  the  month's 
product,  on  the  yearly  crop  of  new  facts,  new  sugges 
tions,  new  contrivances,  as  much  as  the  farmer  on  the 
annual  yield  of  his  acres.  One  of  the  first  wants,  then, 
of  the  profession  is  supplied  by  our  library  in  its  great 
array  of  periodicals  from  many  lands,  in  many  lan 
guages.  Such  a  number  of  medical  periodicals  no 
private  library  would  have  room  for,  no  private  person 
would  pay  for,  or  flood  his  tables  with  if  they  were 
sent  him  for  nothing.  These,  I  think,  with  the  reports 
of  medical  societies  and  the  papers  contributed  to  them, 
will  form  the  most  attractive  part  of  our  accumulated 
medical  treasures.  They  will  be  also  one  of  our  chief 
expenses,  for  these  journals  must  be  bound  in  volumes 
and  they  require  a  great  amount  of  shelf-room ;  all 
this,  in  addition  to  the  cost  of  subscription  for  those 
which  are  not  furnished  us  gratuitously. 

It  is  true  that  the  value  of  old  scientific  periodicals 
is,  other  things  being  equal,  in  the  inverse  ratio  of 
their  age,  for  the  obvious  reason  that  what  is  most 
valuable  in  the  earlier  volumes  of  a  series  is  drained 
off  into  the  standard  works  with  which  the  intelligent 
practitioner  is  supposed  to  be  familiar.  But  no  ex 
tended  record  of  facts  grows  too  old  to  be  useful,  pro 
vided  only  that  we  have  a  ready  .and  sure  way  of  get 
ting  at  the  particular  fact  or  facts  we  are  in  search  of. 

And  this  leads  me  to  speak  of  what  I  conceive  to  bo 
one  of  the  principal  tasks  to  be  performed  by  the  pres- 


402  MEDICAL  ESSAYS. 

ent  and  the  coming  generation  of  scholars,  not  onlj 
in  the  medical,  but  in  every  department  of  knowledge. 
I  mean  the  formation  of  indexes,  and  more  especially 
of  indexes  to  periodical  literature. 

This  idea  has  long  been  working  in  the  minds  of 
scholars,  and  all  who  have  had  occasion  to  follow  out 
any  special  subject.  I  have  a  right  to  speak  of  it,  for 
I  long  ago  attempted  to  supply  the  want  of  indexes  in 
some  small  measure  for  my  own  need.  I  had  a  very 
complete  set  of  the  "  American  Journal  of  the  Medical 
Sciences ; "  an  entire  set  of  the  "  North  American  Re 
view,"  and  many  volumes  of  the  reprints  of  the  three 
leading  British  quarterlies.  Of  what  use  were  they  to 
me  without  general  indexes?  I  looked  them  all 
through  carefully  and  made  classified  lists  of  all  the 
articles  I  thought  I  should  most  care  to  read.  But  they 
soon  outgrew  my  lists.  The  "  North  American  Review  " 
kept  filling  up  shelf  after  shelf,  rich  in  articles  which  I 
often  wanted  to  consult,  but  what  a  labor  to  find  them, 
until  the  index  of  Mr.  Gushing,  published  a  few  months 
since,  made  the  contents  of  these  hundred  and  twenty 
volumes  as  easily  accessible  as  the  words  in  a  diction 
ary  !  I  had  a  copy  of  good  Dr.  Abraham  Rees's  Cy- 
clopsedia,  a  treasure-house  to  my  boyhood  which  has 
not  lost  its  value  for  me  in  later  years.  But  where  to 
look  for  what  I  wanted  ?  I  wished  to  know,  for  in 
stance,  what  Dr.  Burney  had  to  say  about  singing. 
Who  would  have  looked  for  it  under  the  Italian  word 
cantare?  I  was  curious  to  learn  something  of  the 
etchings  of  Rembrandt,  and  where  should  I  find  it  but 
under  the  head  "  Low  Countries,  Engravers  of  the," 
—  an  elaborate  and  most  valuable  article  of  a  hundred 
double-columned  close-printed  quarto  pages,  to  which 
uo  reference,  even,  is  made  under  the  title  Rembrandt. 


MEDICAL  LIBRAEIES.  403 

There  was  nothing  to  be  done,  if  I  wanted  to  know 
where  that  which  I  specially  cared  for  was  to  be  found 
in  my  Rees's  Cyclopaedia,  but  to  look  over  every  page 
of  its  forty-one  quarto  volumes  and  make  out  a  brief 
list  of  matters  of  interest  which  I  could  not  find  by 
their  titles,  and  this  I  did,  at  no  small  expense  of  time 
and  trouble. 

Nothing,  therefore,  could  be  more  pleasing  to  me 
than  to  see  the  attention  which  has  been  given  of  late 
years  to  the  great  work  of  indexing.  It  is  a  quarter 
of  a  century  since  Mr.  Poole  published  his  "  Index  to 
Periodical  Literature,"  which  it  is  much  to  be  hoped  is 
soon  to  appear  in  a  new  edition,  grown  as  it  must  be  to 
formidable  dimensions  by  the  additions  of  so  long  a 
period.  The  "  British  and  Foreign  Medical  Review," 
edited  by  the  late  Sir  John  Forbes,  contributed  to  by 
Huxley,  Carpenter,  Laycock,  and  others  of  the  most 
distinguished  scientific  men  of  Great  Britain,  has  an 
index  to  its  twenty-four  volumes,  and  by  its  aid  I  find 
this  valuable  series  as  manageable  as  a  lexicon.  The  last 
edition  of  the  "  Encyclopzedia  Britannica  "  had  a  com 
plete  index  in  a  separate  volume,  and  the  publishers  of 
Appletons'  "  American  Cyelopzedia  "  have  recently  is 
sued  an  index  to  their  useful  work,  which  must  greatly 
add  to  its  value.  I  have  already  referred  to  the  index  to 
the  "  North  American  Review,"  which  to  an  American, 
and  especially  to  a  New  Englander,  is  the  most  inter 
esting  and  most  valuable  addition  of  its  kind  to  our  liter 
ary  apparatus  since  the  publication  of  Mr.  AUibone's 
"Dictionary  of  Authors."  I  might  almost  dare  to 
parody  Mr.  Webster's  words  in  speaking  of  Hamilton, 
to  describe  what  Mr.  Gushing  did  for  the  solemn  rows 
of  back  volumes  of  our  honored  old  Review  which  had 
'>een  long  fossilizing  on  our  shelves :  "  He  touched  the 


404  MEDICAL  ESSAYS, 

dead  corpse  of  the  "  "  North  American,"  "  and  it  sprang 
to  its  feet."  A  library  of  the  best  thought  of  the  best 
American  scholars  during  the  greater  portion  of  the 
century  was  brought  to  light  by  the  work  of  the  index- 
maker  as  truly  as  were  the  Assyrian  tablets  by  the 
labors  of  Layard. 

A  great  portion  of  the  best  writing  and  reading  — 
literary,  scientific,  professional,  miscellaneous  —  comes 
to  us  now,  at  stated  intervals,  in  paper  covers.  The 
writer  appears,  as  it  were,  in  his  shirt-sleeves.  As  soon 
as  he  has  delivered  his  message  the  book-binder  puts  a 
coat  on  his  back,  and  he  joins  the  forlorn  brotherhood 
of  "  back  volumes,"  than  which,  so  long  as  they  are 
unindexed,  nothing  can  be  more  exasperating.  Who 
wants  a  lock  without  a  key,  a  ship  without  a  rudder,  a 
binnacle  without  a  compass,  a  check  without  a  signa 
ture,  a  greenback  without  a  goldback  behind  it  ? 

I  have  referred  chiefly  to  the  medical  journals,  but  I 
would  include  with  these  the  reports  of  medical  associa 
tions,  and  those  separate  publications  which,  coming 
in  the  form  of  pamphlets,  heap  themselves  into  chaotic 
piles  and  bundles  which  are  worse  than  useless,  taking 
up  a  great  deal  of  room,  and  frightening  everything 
away  but  mice  and  mousing  antiquarians,  or  possibly 
at  long  intervals  some  terebrating  specialist. 

Arranged,  bound,  indexed,  all  these  at  once  be 
come  accessible  and  valuable.  I  will  take  the  first  in 
stance  which  happens  to  suggest  itself.  How  many 
who  know  all  about  osteoblasts  and  the  experiments  of 
Oilier,  and  all  that  has  grown  out  of  them,  know  where 
to  go  for  a  paper  by  the  late  Dr.  A.  L.  Peirson  of 
Salem,  published  in  the  year  1840,  under  the  modest 
title,  Remarks  on  Fractures  ?  And  if  any  practitioner 
who  has  to  deal  with  broken  bones  does  not  know  that 


MEDICAL  LIBRARIES.  405 

most  excellent  and  practical  essay,  it  is  a  great  pity, 
for  it  answers  very  numerous  questions  which  will  be 
sure  to  suggest  themselves  to  the  surgeon  and  the  pa 
tient  as  no  one  of  the  recent  treatises,  on  my  own 
shelves,  at  least,  can  do. 

But  if  indexing  is  the  special  need  of  our  time  in 
medical  literature,  as  in  every  department  of  knowl 
edge,  it  must  be  remembered  that  it  is  not  only  an  im 
mense  labor,  but  one  that  never  ends.  It  requires, 
therefore,  the  cooperation  of  a  large  number  of  individ 
uals  to  do  the  work,  and  a  large  amount  of  money  to 
pay  for  making  its  results  public  through  the  press. 
When  it  is  remembered  that  the  catalogue  of  the 
library  of  the  British  Museum  is  contained  in  nearly 
three  thousand  large  folios  of  manuscript,  and  not  all 
its  books  are  yet  included,  the  task  of  indexing  any 
considerable  branch  of  science  or  literature  looks  as  if 
it  were  well  nigh  impossible.  But  many  hands  make 
light  work.  An  "  Index  Society  "  has  been  formed  in 
England,  already  numbering  about  one  hundred  and 
seventy  members.  It  aims  at  "supplying  thorough 
indexes  to  valuable  works  and  collections  which  have 
hitherto  lacked  them ;  at  issuing  indexes  to  the  liter 
ature  of  special  subjects ;  and  at  gathering  materials 
for  a  general  reference  index."  This  society  has  pub 
lished  a  little  treatise  setting  forth  the  history  and  the 
art  of  indexing,  which  I  trust  is  in  the  hands  of  some 
of  our  members,  if  not  upon  our  shelves. 

Something  has  been  done  in  the  same  direction  by 
individuals  in  our  own  country,  as  we  have  already 
seen.  The  need  of  it  in  the  department  of  medicine 
is  beginning  to  be  clearly  felt.  Our  library  has  al 
ready  an  admirable  catalogue  with  cross  references, 
the  work  of  a  number  of  its  younger  members  coop 


406  MEDICAL   ESSAYS. 

erating  in  the  task.  A  very  intelligent  medical  stu 
dent,  Mr.  William  D.  Chapin,  whose  excellent  project 
is  indorsed  by  well-known  New  York  physicians  and 
professors,  proposes  to  publish  a  yearly  index  to  orig 
inal  communications  in  the  medical  journals  of  the 
United  States,  classified  by  authors  and  subjects.  But 
it  is  from  the  National  Medical  Library  at  Washing 
ton  that  we  have  the  best  promise  and  the  largest  ex 
pectations.  That  great  and  growing  collection  of  fifty 
thousand  volumes  is  under  the  eye  and  hand  of  a  li 
brarian  who  knows  books  and  how  to  manage  them. 
For  libraries  are  the  standing  armies  of  civilization^ 
and  an  army  is  but  a  mob  without  a  general  who  can 
organize  and  marshal  it  so  as  to  make  it  effective. 
The  "  Specimen  Fasciculus  of  a  Catalogue  of  the  Na 
tional  Medical  Library,"  prepared  under  the  direction 
of  Dr.  Billings,  the  librarian,  would  have  excited  the 
admiration  of  Haller,  the  master  scholar  in  medical 
science  of  the  last  century,  or  rather  of  the  profession 
in  all  centuries,  and  if  carried  out  as  it  is  begun  will 
be  to  the  nineteenth  all  and  more  than  all  that  the 
three  Bibliothecse  —  Anatomica,  Chirurgica,  and  Med- 
icina3-Practicae  —  were  to  the  eighteenth  century.  I 
cannot  forget  the  story  that  Agassiz  was  so  fond  of 
telling  of  the  king  of  Prussia  and  Fichte.  It  was  after 
the  humiliation  and  spoliation  of  the  kingdom  by  Na 
poleon  that  the  monarch  asked  the  philosopher  what 
could  be  done  to  regain  the  lost  position  of  the  nation. 
"  Found  a  great  university,  Sire,"  was  the  answer,  and 
so  it  was  that  in  the  year  1810  the  world-renowned 
University  of  Berlin  came  into  being.  I  believe  that 
we  in  this  country  can  do  better  than  found  a  national 
university,  whose  professors  shall  be  nominated  in 
caucuses,  go  in  and  out,  perhaps,  like  postmasters 


MEDICAL   LIBRARIES.  40T 

with  every  change  of  administration,  and  deal  witl, 
science  in  the  face  of  their  constituency  as  the  courtier 
did  with  time  when  his  sovereign  asked  him  what 
o'clock  it  was :  "  Whatever  hour  your  majesty  pleases.'* 
But  when  we  have  a  noble  library  like  that  at  Wash 
ington,  and  a  librarian  of  exceptional  qualifications 
like  the  gentleman  who  now  holds  that  office,  I  believe 
that  a  liberal  appropriation  by  Congress  to  carry  out 
a  conscientious  work  for  the  advancement  of  sound 
knowledge  and  the  bettering  of  human  conditions,  like 
this  which  Dr.  Billings  has  so  well  begun,  would  re 
dound  greatly  to  the  honor  of  the  nation.  It  ought  to 
be  willing  to  be  at  some  charge  to  make  its  treasures 
useful  to  its  citizens,  and,  for  its  own  sake,  especially 
to  that  class  which  has  charge  of  health,  public  and 
private.  This  country  abounds  in  what  are  called 
"  self-made  men,"  and  is  justly  proud  of  many  whom 
it  thus  designates.  In  one  sense  no  man  is  self-made 
who  breathes  the  air  of  a  civilized  community.  In  an 
other  sense  every  man  who  is  anything  other  than  a 
phonograph  on  legs  is  self-made.  But  if  we  award  his 
just  praise  to  the  man  who  has  attained  any  kind  of 
excellence  without  having  had  the  same  advantages  as 
others  whom,  nevertheless,  he  has  equalled  or  sur 
passed,  let  us  not  be  betrayed  into  undervaluing  the 
mechanic's  careful  training  to  his  business,  the  thor 
ough  and  laborious  education  of  the  scholar  and  the 
professional  man. 

Our  American  atmosphere  is  vocal  with  the  flippant 
loquacity  of  half  knowledge.  We  must  accept  what 
ever  good  can  be  got  out  of  it,  and  keep  it  under  as 
we  do  sorrel  and  mullein  and  witchgrass,  by  enriching 
the  soil,  and  sowing  good  seed  in  plenty;  by  good 
teaching  and  good  books,  rather  than  by  wasting  oitf 


408  MEDICAL  ESSAYS. 

tamo  in  talking  against  it.  Half  knowledge  dreada 
nothing  but  whole  knowledge. 

I  have  spoken  of  the  importance  and  the  predomi 
nance  of  periodical  literature,  and  have  attempted  to 
do  justice  to  its  value.  But  the  almost  exclusive  read 
ing  of  it  is  not  without  its  dangers.  The  journals  con 
tain  much  that  is  crude  and  unsound ;  the  presump 
tion,  it  might  be  maintained,  is  against  their  novelties, 
unless  they  come  from  observers  of  established  credit. 
Yet  I  have  known  a  practitioner,  —  perhaps  more  than 
one,  —  who  was  as  much  under  the  dominant  influence 
of  the  last  article  he  had  read  in  his  favorite  medical 
journal  as  a  milliner  under  the  sway  of  the  last  fash 
ion-plate.  The  difference  between  green  and  seasoned 
knowledge  is  very  great,  and  such  practitioners  never 
hold  long  enough  to  any  of  their  knowledge  to  have  it 
get  seasoned. 

It  is  needless  to  say,  then,  that  all  the  substantial 
and  permanent  literature  of  the  profession  should  be 
represented  upon  our  shelves.  Much  of  it  is  there  al 
ready,  and  as  one  private  library  after  another  falls 
into  this  by  the  natural  law  of  gravitation,  it  will  grad 
ually  acquire  all  that  is  most  valuable  almost  without 
effort.  A  scholar  should  not  be  in  a  hurry  to  part 
with  his  books.  They  are  probably  more  valuable  to 
him  than  they  can  be  to  any  other  individual.  What 
Swedenborg  called  "  correspondence  "  has  established 
itself  between  his  intelligence  and  the  volumes  which 
wall  him  within  their  sacred  inclosure.  Napoleon  said 
that  his  mind  was  as  if  furnished  with  drawers,  —  he 
drew  out  each  as  he  wanted  its  contents,  and  closed  it 
at  will  when  done  with  them.  The  scholar's  mind,  to 
use  a  similar  comparison,  is  furnished  with  shelves, 
like  his  library.  Each  book  knows  its  place  in  the 


MEDICAL   LIBRARIES.  409 

brain  as  well  as  against  the  wall  or  in  the  alcove.  His 
consciousness  is  doubled  by  the  books  which  encircle 
him,  as  the  trees  that  surround  a  lake  repeat  them 
selves  in  its  unruffled  waters.  Men  talk  of  the  nerve 
that  runs  to  the  pocket,  but  one  who  loves  his  books, 
and  has  lived  long  with  them,  has  a  nervous  filament 
which  runs  from  his  sensoriuni  to  every  one  of  them. 
Or,  if  I  may  still  let  my  fancy  draw  its  pictures,  a 
scholar's  library  is  to  him  what  a  temple  is  to  the  wor 
shipper  who  frequents  it.  There  is  the  altar  sacred  to 
his  holiest  experiences.  There  is  the  font  where  his 
new-born  thought  was  baptized  and  first  had  a  name 
in  his  consciousness.  There  is  the  monumental  tablet 
of  a  dead  belief,  sacred  still  in  the  memory  of  what  it 
was  while  yet  alive.  No  visitor  can  read  all  this  on 
the  lettered  backs  of  the  books  that  have  gathered 
around  the  scholar,  but  for  him,  from  the  Aldus  on 
the  lowest  shelf  to  the  Elzevir  on  the  highest,  every 
volume  has  a  language  which  none  but  he  can  inter 
pret.  Be  patient  with  the  book-collector  who  loves  his 
companions  too  well  to  let  them  go.  Books  are  not 
buried  with  their  owners,  and  the  veriest  book-miser 
that  ever  lived  was  probably  doing  far  more  for  his 
successors  than  his  more  liberal  neighbor  who  despised 
his  learned  or  unlearned  avarice.  Let  the  fruit  fall 
with  the  leaves  still  clinging  round  it.  Who  would 
have  stripped  Southey's  walls  of  the  books  that  filled 
them,  when,  his  mind  no  longer  capable  of  taking  in 
their  meaning,  he  would  still  pat  and  fondle  them  with 
the  vague  loving  sense  of  what  they  had  once  been  to 
him,  —  to  him,  the  great  scholar,  now  like  a  little  child 
among  his  playthings  ? 

We  need  in  this  country  not  only  the  scholar,  but  the 
virtuoso,  who  hoards  the  treasures  which  he  loves,  it 


410  MEDICAL  ESSAYS. 

may  be  chiefly  for  their  rarity  and  because  others  who 
know  more  than  he  does  of  their  value  set  a  high  price 
upon  them.  As  the  wine  of  old  vintages  is  gently  de 
canted  out  of  its  cobwebbed  bottles  with  their  rotten 
corks  into  clean  new  receptacles,  so  the  wealth  of  the 
New  World  is  quietly  emptying  many  of  the  libraries 
and  galleries  of  the  Old  World  into  its  newly  formed 
collections  and  newly  raised  edifices.  And  this  process 
must  go  on  in  an  accelerating  ratio.  No  Englishman 
will  be  offended  if  I  say  that  before  the  New  Zealander 
takes  his  stand  on  a  broken  arch  of  London  Bridge  to 
sketch  the  ruins  of  St.  Paul's  in  the  midst  of  a  vast 
solitude,  the  treasures  of  the  British  Museum  will  have 
found  a  new  shelter  in  the  halls  of  New  York  or  Bos 
ton.  No  Catholic  will  think  hardly  of  my  saying  that 
before  the  Coliseum  falls,  and  with  it  the  imperial  city, 
whose  doom  prophecy  has  linked  with  that  of  the  al 
most  eternal  amphitheatre,  the  marbles,  the  bronzes, 
the  paintings,  the  manuscripts  of  the  Vatican  will  have 
left  the  shores  of  the  Tiber  for  those  of  the  Potomac, 
the  Hudson,  the  Mississippi,  or  the  Sacramento.  And 
what  a  delight  in  the  pursuit  of  the  rarities  which  tho 
eager  book-hunter  follows  with  the  scent  of  a  beagle  * 
Shall  I  ever  forget  that  rainy  day  in  Lyons,  that  ding^ 
bookshop,  where  I  found  the  Aetius,  long  missing  from 
my  Artis  Medicas  Principes,  and  where  I  bought  for 
a  small  pecuniary  consideration,  though  it  was  marked 
rare,  and  was  really  tres  rare,  the  Aphorisms  of  Hip 
pocrates,  edited  by  and  with  a  preface  from  the  hand 
of  Francis  Rabelais  ?  And  the  vellum-bound  Tulpius, 
which  I  came  upon  in  Venice,  afterwards  my  only 
reading  when  imprisoned  in  quarantine  at  Marseilles, 
BO  that  the  two  hundred  and  twenty-eight  cases  he  has 
recorded  are,  many  of  them,  to  this  day  still  fresh  in 


MEDICAL   LIBRARIES.  411 

my  memory.  And  the  Schenckius,—  -the  folio  filled 
with  casus  rariores,  which  had  strayed  in  among  the 
rubbish  of  the  bookstall  on  the  boulevard,  —  and  the 
noble  old  Vesalius  with  its  grand  frontispiece  not  un 
worthy  of  Titian,  and  the  fine  old  Ambroise  Pare",  long 
waited  for  even  in  Paris  and  long  ago,  and  the  colos 
sal  Spigelius  with  his  eviscerated  beauties,  and  Dutch 
Bidloo  with  its  miracles  of  fine  engraving  and  bad  dis 
section,  and  Italian  Mascagni,  the  despair  of  all  would- 
be  imitators,  and  pre- Adamite  John  de  Ketam,  and 
antediluvian  Berengarius  Carpensis,  —  but  why  multi 
ply  names,  every  one  of  which  brings  back  the  acces 
sion  of  a  book  which  was  an  event  almost  like  the  birth 
of  an  infant? 

A  library  like  ours  must  exercise  the  largest  hospi 
tality.  A  great  many  books  may  be  found  in  every 
large  collection  which  remind  us  of  those  apostolic 
looking  old  men  who  figure  on  the  platform  at  our 
political  and  other  assemblages.  Some  of  them  have 
spoken  words  of  wisdom  in  their  day,  but  they  have 
ceased  to  be  oracles ;  some  of  them  never  had  any  par 
ticularly  important  message  for  humanity,  but  they  add 
dignity  to  the  meeting  by  their  presence ;  they  look 
wise,  whether  they  are  so  or  not,  and  no  one  grudges 
them  their  places  of  honor.  Venerable  figure-heads, 
what  would  our  platforms  be  without  you  ? 

Just  so  with  our  libraries.  Without  their  rows  of 
folios  in  creamy  vellum,  or  showing  their  black  backs 
with  antique  lettering  of  tarnished  gold,  our  shelves 
would  look  as  insufficient  and  unbalanced  as  a  column 
without  its  base,  as  a  statue  without  its  pedestal.  And 
do  not  think  they  are  kept  only  to  be  spanked  and' 
dusted  during  that  dreadful  period  when  their  owner 
is  but  too  thankful  to  become  an  exile  and  a  wanderer 


412  MEDICAL  ESSAYS. 

from  the  scene  of  single  combats  between  dead  authors 
and  living  housemaids.  Men  were  not  all  cowards 
before  Agamemnon  or  all  fools  before  the  days  of  Vir- 
chow  and  Billroth.  And  apart  from  any  practical  use 
to  be  derived  from  the  older  medical  authors,  is  there 
not  a  true  pleasure  in  reading  the  accounts  of  great 
discoverers  in  their  own  words  ?  I  do  not  pretend  to 
hoist  up  the  Bibliotheca  Anatomica  of  Mangetus  and 
spread  it  on  my  table  every  day.  I  do  not  get  out  my 
great  Albinus  before  every  lecture  on  the  muscles,  nor 
disturb  the  majestic  repose  of  Vesalius  every  time  I 
speak  of  the  bones  he  has  so  admirably  described  and 
figured.  But  it  does  please  me  to  read  the  first  de 
scriptions  of  parts  to  which  the  names  of  their  discover 
ers  or  those  who  have  first  described  them  have  become 
so  joined  that  not  even  modern  science  can  part  them ; 
to  listen  to  the  talk  of  my  old  volume  as  Willis  de 
scribes  his  circle  and  Fallopius  his  aqueduct  and  Varo- 
lius  his  bridge  and  Eustachius  his  tube  and  Monro 
his  foramen,  —  all  so  well  known  to  us  in  the  human 
body ;  it  does  please  me  to  know  the  very  words  in 
which  Winslow  described  the  opening  which  bears  his 
name,  and  Glisson  his  capsule  and  De  Graaf  his  vesi 
cle  ;  I  am  not  content  until  I  know  in  what  language 
Harvey  announced  his  discovery  of  the  circulation,  and 
how  Spigelius  made  the  liver  his  perpetual  memorial, 
and  Malpighi  found  a  monument  more  enduring  than 
brass  in  the  corpuscles  of  the  spleen  and  the  kidney. 

But  after  all,  the  readers  who  care  most  for  the 
early  records  of  medical  science  and  art  are  the  spe 
cialists  who  are  dividing  up  the  practice  of  medicine 
and  surgery  as  they  were  parcelled  out,  according  to 
Herodotus,  by  the  Egyptians.  For  them  nothing  is 
too  old,  nothing  is  too  new,  for  to  their  books  of  all 


MEDICAL   LIBRARIES.  413 

others  is  applicable  the  saying  of  D'Alembert  that  the 
author  kills  himself  in  lengthening  out  what  the  reader 
kills  himself  in  trying  to  shorten. 

There  are  practical  books  among  these  ancient  vol 
umes  which  can  never  grow  old.  Would  you  know 
how  to  recognize  "  male  hysteria  "  and  to  treat  it,  take 
down  your  Sydenham ;  would  you  read  the  experience 
of  a  physician  who  was  himself  the  subject  of  asthma, 
and  who,  notwithstanding  that,  in  the  words  of  Dr. 
Johnson,  "  panted  on  till  ninety,"  you  will  find  it  in 
the  venerable  treatise  of  Sir  John  Floyer ;  would  you 
listen  to  the  story  of  the  King's  Evil  cured  by  the  royal 
touch,  as  told  by  a  famous  chirurgeon  who  fully  be 
lieved  in  it,  go  to  Wiseman ;  would  you  get  at  first 
hand  the  description  of  the  spinal  disease  which  long 
bore  his  name,  do  not  be  startled  if  I  tell  you  to  go  to 
Pott, — to  Percival  Pott,  the  great  surgeon  of  the  last 
century. 

There  comes  a  time  for  every  book  in  a  library  when 
it  is  wanted  by  somebody.  It  is  but  a  few  weeks  since 
one  of  the  most  celebrated  physicians  in  the  country 
wrote  to  me  from  a  great  centre  of  medical  education 
to  know  if  I  had  the  works  of  Sanctorius,  which  he  had 
tried  in  vain  to  find.  I  could  have  lent  him  the  "  Me- 
dicina  Statica,"  with  its  frontispiece  showing  Sancto 
rius  with  his  dinner  on  the  table  before  him,  in  his  bal 
anced  chair  which  sunk  with  him  below  the  level  of 
his  banquet-board  when  he  had  swallowed  a  certain 
number  of  ounces,  —  an  early  foreshadowing  of  Pet- 
tenkofer's  chamber  and  quantitative  physiology,  —  but 
the  "  Opera  Omnia "  of  Sanctorius  I  had  never  met 
with,  and  I  fear  he  had  to  do  without  it. 

I  would  extend  the  hospitality  of  these  shelves  to  a 
class  of  works  which  we  are  in  the  habit  of  considering 


414  MEDICAL  ESSAYS. 

as  being  outside  of  the  pale  of  medical  science,  proj> 
erly  so  called,  and  sometimes  of  coupling  with  a  dis 
respectful  name.  Such  has  always  been  my  own  prac 
tice.  I  have  welcomed  Culpeper  and  Salmon  to  my 
bookcase  as  willingly  as  Dioscorides  or  Quincy,  or 
Paris  or  Wood  and  Bache.  I  have  found  a  place  for 
St.  John  Long,  and  read  the  story  of  his  trial  for  man 
slaughter  with  as  much  interest  as  the  laurel- water  case 
in  which  John  Hunter  figured  as  a  witness.  I  would 
give  Samuel  Hahnemann  a  place  by  the  side  of  Samuel 
Thomson.  Am  I  not  afraid  that  some  student  of  imag 
inative  turn  and  not  provided  with  the  needful  cere 
bral  strainers  without  which  all  the  refuse  of  gimcrack 
intelligences  gets  into  the  mental  drains  and  chokes 
them  up,  —  am  I  not  afraid  that  some  such  student 
will  get  hold  of  the  "  Organon  "  or  the  "  Maladies 
Chroniques  "  and  be  won  over  by  their  delusions,  and 
so  be  lost  to  those  that  love  him  as  a  man  of  common 
sense  and  a  brother  in  their  high  calling  ?  Not  in  the 
least.  If  he  showed  any  symptoms  of  infection  I 
would  for  once  have  recourse  to  the  principle  of  similia 
similibus.  To  cure  him  of  Hahnemann  I  would  pre 
scribe  my  favorite  homeopathic  antidote,  Okie's  Bon- 
ninghausen.  If  that  failed,  I  would  order  Grauvogl 
as  a  heroic  remedy,  and  if  he  survived  that  uncured,  I 
would  give  him  my  blessing,  if  I  thought  him  honest, 
and  bid  him  depart  in  peace.  For  me  he  is  no  longer 
an  individual.  He  belongs  to  a  class  of  minds  which  we 
are  bound  to  be  patient  with  if  their  Maker  sees  fit  to 
indulge  them  with  existence.  We  must  accept  the 
conjuring  ultra-ritualist,  the  dreamy  second  adventist, 
the  erratic  spiritualist,  the  fantastic  homo3Opathist,  as 
not  unworthy  of  philosophic  study ;  not  more  unworthy 
of  it  than  the  squarers  of  the  circle  and  the  inventors 


MEDICAL  LIBRARIES.  415 

of  perpetual  motion,  and  the  other  whimsical  vision 
aries  to  whom  De  Morgan  has  devoted  his  most  in 
structive  and  entertaining  "  Budget  of  Paradoxes."  I 
hope,  therefore,  that  our  library  will  admit  the  works 
of  the  so-called  Eclectics,  of  the  Thomsonians,  if  any 
are  in  existence,  of  the  Clairvoyants,  if  they  have  a 
literature,  and  especially  of  the  Homoeopathists.  This 
country  seems  to  be  the  place  for  such  a  collection, 
which  will  by  and  by  be  curious  and  of  more  value 
than  at  present,  for  Homeopathy  seems  to  be  fol 
lowing  the  pathological  law  of  erysipelas,  fading  out 
where  it  originated  as  it  spreads  to  new  regions.  At 
least  I  judge  so  by  the  following  translated  extract 
from  a  criticism  of  an  American  work  in  the  "  Homoeo- 
patische  Rundschau"  of  Leipzig  for  October,  1878, 
which  I  find  in  the  "  Homoeopathic  Bulletin  "  for  the 
month  of  November  just  passed :  — 

"  While  we  feel  proud  of  the  spread  and  rise  of  Ho 
moeopathy  across  the  ocean,  and  while  the  Homoeo 
pathic  works  reaching  us  from  there,  and  published  in 
a  style  such  as  is  unknown  in  Germany,  bear  eloquent 
testimony  to  the  eminent  activity  of  our  transatlantic 
colleagues,  we  are  overcome  by  sorrowful  regrets  at 
the  position  Homoeopathy  occupies  in  Germany.  Such 
a  work  [as  the  American  one  referred  to]  with  us 
would  be  impossible  ;  it  would  lack  the  necessary  sup 
port." 

By  all  means  let  our  library  secure  a  good  represen 
tation  of  the  literature  of  Homoeopathy  before  it  leaves 
us  its  "  sorrowful  regrets  "  and  migrates  with  its  sugar 
of  milk  pellets,  which  have  taken  the  place  of  the  old 
pilulce  micce  panis,  to  Alaska,  to  "  Nova  Zembla,  or 
the  Lord  knows  where." 

What  shall  I  say  in  this  presence  of  the  duties  of  a 


416  MEDICAL   ESSAYS. 

Librarian?  Where  have  they  ever  been  better  per* 
formed  than  in  our  own  public  city  library,  where  the 
late  Mr.  Jewett  and  the  living  Mr.  Winsor  have  shown 
us  what  a  librarian  ought  to  be,  —  the  organizing  head, 
the  vigilant  guardian,  the  seeker's  index,  the  scholar's 
counsellor  ?  His  work  is  not  merely  that  of  adminis 
tration,  manifold  and  laborious  as  its  duties  are.  He 
must  have  a  quick  intelligence  and  a  retentive  memory. 
He  is  a  public  carrier  of  knowledge  in  its  germs.  His 
office  is  like  that  which  naturalists  attribute  to  the 
bumble-bee,  —  he  lays  up  little  honey  for  himself,  but 
he  conveys  the  fertilizing  pollen  from  flower  to  flower. 

Our  undertaking,  just  completed,  —  and  just  begun 
—  has  come  at  the  right  time,  not  a  day  too  soon. 
Our  practitioners  need  a  library  like  this,  for  with  all 
their  skill  and  devotion  there  is  too  little  genuine  eru 
dition,  such  as  a  liberal  profession  ought  to  be  able  to 
claim  for  many  of  its  members.  In  reading  the  recent 
obituary  notices  of  the  late  Dr.  Geddings  of  South 
Carolina,  I  recalled  what  our  lamented  friend  Dr. 
Coale  used  to  tell  me  of  his  learning  and  accomplish 
ments,  and  I  could  not  help  reflecting  how  few  such 
medical  scholars  we  had  to  show  in  Boston  or  New 
England.  We  must  clear  up  this  unilluminated  atmos 
phere,  and  here,  —  here  is  the  true  electric  light  which 
will  irradiate  its  darkness. 

The  public  will  catch  the  rays  reflected  from  the 
same  source  of  light,  and  it  needs  instruction  on  the 
great  subjects  of  health  and  disease,  —  needs  it  sadly. 
It  is  preyed  upon  by  every  kind  of  imposition  almost 
without  hindrance.  Its  ignorance  and  prejudices  re 
act  upon  the  profession  to  the  great  injury  of  both. 
The  jealous  feeling,  for  instance,  with  regard  to  such 
provisions  for  the  study  of  anatomy  as  are  sanctioned 


MEDICAL  LIBRARIES.  417 

by  the  laws  in  this  State  and  carried  out  with  strict  re 
gard  to  those  laws,  threatens  the  welfare,  if  not  the  ex 
istence  of  institutions  for  medical  instruction  wherever 
it  is  not  held  in  check  by  enlightened  intelligence. 
And  on  the  other  hand  the  profession  has  just  been 
startled  by  a  verdict  against  a  physician,  ruinous  in 
its  amount,  —  enough  to  drive  many  a  hard-working 
young  practitioner  out  of  house  and  home,  —  a  verdict 
which  leads  to  the  fear  that  suits  for  malpractice  may 
take  the  place  of  the  panel  game  and  child-stealing  as 
a  means  of  extorting  money.  If  the  profession  in  this 
State,  which  claims  a  high  standard  of  civilization,  is 
to  be  crushed  and  ground  beneath  the  upper  millstone 
of  the  dearth  of  educational  advantages  and  the  lower 
millstone  of  ruinous  penalties  for  what  the  ignorant 
ignorantly  shall  decide  to  be  ignorance,  all  I  can 

say  is 

God  save  the  Commonwealth  of  Massachusetts  1 

Once  more,  we  cannot  fail  to  see  that  just  as  astrol 
ogy  has  given  place  to  astronomy,  so  theology,  the 
science  of  Him  whom  by  searching  no  man  can  find 
out,  is  fast  being  replaced  by  what  we  may  not  im 
properly  call  theonomy,  or  the  science  of  the  laws  ac 
cording  to  which  the  Creator  acts.  And  since  these 
laws  find  their  fullest  manifestations  for  us,  at  least, 
in  rational  human  natures,  the  study  of  anthropology 
is  largely  replacing  that  of  scholastic  divinity.  We 
must  contemplate  our  Maker  indirectly  in  human  at 
tributes  as  we  talk  of  Him  in  human  parts  of  speech. 
And  this  gives  a  sacredness  to  the  study  of  man  in  his 
physical,  mental,  moral,  social,  and  religious  nature 
which  elevates  the  faithful  students  of  anthropology 
to  the  dignity  of  a  priesthood,  and  sheds  a  holy  light 
on  the  recorded  results  of  their  labors,  brought  together 


418  MEDICAL  ESSAYS. 

as  they  are  in  such  a  collection  as  this  which  is  no\f 
spread  out  before  us. 

Thus,  then,  our  library  is  a  temple  as  truly  as  the 
dome-crowned  cathedral  hallowed  by  the  breath  of 
prayer  and  praise,  where  the  dead  repose  and  the  living 
worship.  May  it,  with  all  its  treasures,  be  consecrated 
like  that  to  the  glory  of  God,  through  the  contribu 
tions  it  shall  make  to  the  advancement  of  sound 
knowledge,  to  the  relief  of  human  suffering,  to  the 
promotion  of  harmonious  relations  between  the  mem 
bers  of  the  two  noble  professions  which  deal  with  th«_ 
diseases  of  the  soul  and  with  those  of  the  body,  and  to 
the  common  cause  in  which  all  good  men  are  working, 
the  furtherance  of  the  well-being  of  their  fellow-crea 
tures! 

NOTE.  —  As  an  illustration  of  the  statement  in  the 
last  paragraph  but  one,  I  take  the  following  notice 
from  the  "  Boston  Daily  Advertiser,"  of  December 
4th,  the  day  after  the  delivery  of  the  address :  — 

"  Prince  Lucien  Bonaparte  is  now  living  in  London, 
and  is  devoting  himself  to  the  work  of  collecting  the 
creeds  of  all  religions  and  sects,  with  a  view  to  their 
classification,  —  his  object  being  simply  scientific  or 
anthropological." 

Since  delivering  the  address,  also,  I  find  a  leading 
article  in  the  "  Cincinnati  Lancet  and  Clinic  "  of  No 
vember  30th,  headed  "  The  Decadence  of  Home 
opathy,"  abundantly  illustrated  by  extracts  from  the 
"Homoeopathic  Tunes,"  the  leading  American  organ 
of  that  sect. 

In  the  New  York  "  Medical  Record "  of  the  same 
date,  which  I  had  not  seen  before  the  delivery  of  my 
address,  is  an  account  of  the  action  of  the  Homoso 


MEDICAL  LIBRARIES.  419 

pathio  Medical  Society  of  Northern  New  York,  in 
which  Hahnemann's  theory  of  "  dynamization  "  is  char 
acterized  in  a  formal  resolve  as  "  unworthy  the  confi 
dence  of  the  Homosopathic  profession." 

It  will  be  a  disappointment  to  the  German  Homoe- 
opathists  to  read  in  the  "  Homoeopathic  Times  "  such 
a  statement  as  the  following :  — 

"Whatever  the  influences  have  been  which  have 
checked  the  outward  development  of  Homosopathy,  it 
is  plainly  evident  that  the  Homosopathic  school,  as  re 
gards  the  number  of  its  openly  avowed  representatives, 
has  attained  its  majority,  and  has  begun  to  decline 
both  in  this  country  and  in  England." 

All  which  is  an  additional  reason  for  making  a  col 
lection  of  the  incredibly  curious  literature  of  Homos 
opathy  before  that  pseudological  inanity  has  faded  out 
like  so  many  other  delusions. 


IX. 
SOME  OF  MY  EARLY  TEACHERS- 

I  HAD  intended  that  the  recitation  of  Friday  last 
should  be  followed  by  a  few  parting  words  to  my  class 
and  any  friends  who  might  happen  to  be  in  the  lecture- 
room.  But  I  learned  on  the  preceding  evening  that 
there  was  an  expectation,  a  desire,  that  my  farewell 
should  take  a  somewhat  different  form ;  and  not  to 
disappoint  the  wishes  of  those  whom  I  was  anxious  to 
gratify,  I  made  up  my  mind  to  appear  before  you  with 
such  hasty  preparation  as  the  scanty  time  admitted. 

There  are  three  occasions  upon  which  a  human  be 
ing  has  a  right  to  consider  himself  as  a  centre  of  inter 
est  to  those  about  him :  when  he  is  christened,  when  he 
is  married,  and  when  he  is  buried.  Every  one  is  the 
chief  personage,  the  hero,  of  his  own  baptism,  his  own 
wedding,  and  his  own  funeral. 

There  are  other  occasions,  less  momentous,  in  which 
one  may  make  more  of  himself  than  under  ordinary 
circumstances  he  would  think  it  proper  to  do;  when 
he  may  talk  about  himself,  and  tell  his  own  experi 
ences,  in  fact,  indulge  in  a  more  or  less  egotistic  mono 
logue  without  fear  or  reproach. 

I  think  I  may  claim  that  this  is  one  of  those  occa 
sions.  I  have  delivered  my  last  anatomical  lecture 

•  A  Farewell  Address  to  the  Medical  School  of  Harvard  Uni 
versity,  November  28,  1882. 


SOME  OF  MY  EARLY  TEACHERS. 

and  heard  my  class  recite  for  the  last  time.  They 
wish  to  hear  from  me  again  in  a  less  scholastic  mood 
than  that  in  which  they  have  known  me.  Will  you 
not  indulge  me  in  telling  you  something  of  my  own 
story  ? 

This  is  the  thirty-sixth  Course  of  Lectures  in  which 
I  have  taken  my  place  and  performed  my  duties  as 
Professor  of  Anatomy.  For  more  than  half  of  my  term 
of  office  I  gave  instruction  in  Physiology,  after  the 
fashion  of  my  predecessors  and  in  the  manner  then 
generally  prevalent  in  our  schools,  where  the  physio 
logical  laboratory  was  not  a  necessary  part  of  the  ap 
paratus  of  instruction.  It  was  with  my  hearty  ap 
proval  that  the  teaching  of  Physiology  was  constituted 
a  separate  department  and  made  an  independent  Pro 
fessorship.  Before  my  time,  Dr.  Warren  had  taught 
Anatomy,  Physiology,  and  Surgery  in  the  same  course 
of  Lectures,  lasting  only  three  or  four  months.  As 
the  boundaries  of  science  are  enlarged,  new  divisions 
and  subdivisions  of  its  territories  become  necessary. 
In  the  place  of  six  Professors  in  1847,  when  I  first  be 
came  a  member  of  the  Faculty,  I  count  twelve  upon 
the  Catalogue  before  me,  and  I  find  the  whole  number 
engaged  in  the  work  of  instruction  in  the  Medical 
School  amounts  to  no  less  than  fifty. 

Since  I  began  teaching  in  this  school,  the  aspect  of 
many  branches  of  science  has  undergone  a  very  re 
markable  transformation.  Chemistry  and  Physiology 
are  no  longer  what  they  were,  as  taught  by  the  in 
structors  of  that  time.  We  are  looking  forward  to 
the  synthesis  of  new  organic  compounds  j  our  artificial 
madder  is  already  in  the  market,  and  the  indigo-raisers 
are  now  fearing  that  their  crop  will  be  supplanted  by 
the  manufactured  article.  In  the  living  body  we  talk 


422  MEDICAL  ESSAYS. 

of  fuel  supplied  and  work  done,  in  movement,  in  heat, 
just  as  if  we  were  dealing  with  a  machine  of  our  own 
contrivance.  A  physiological  laboratory  of  to-day  is 
equipped  with  instruments  of  research  of  such  ingen 
ious  contrivance,  such  elaborate  construction,  that  one 
might  suppose  himself  in  a  workshop  where  some  ex 
quisite  fabric  was  to  be  wrought,  such  as  Queens  love 
to  wear,  and  Kings  do  not  always  love  to  pay  for. 
They  are,  indeed,  weaving  a  charmed  web,  for  these 
are  the  looms  from  which  comes  the  knowledge  that 
clothes  the  nakedness  of  the  intellect.  Here  are  the 
mills  that  grind  food  for  its  hunger,  and  "  is  not  the 
life  more  than  meat,  and  the  body  than  raiment  ?  " 

But  while  many  of  the  sciences  have  so  changed 
that  the  teachers  of  the  past  would  hardly  know  them, 
it  has  not  been  so  with  the  branch  I  teach,  or,  rather, 
with  that  division  of  it  which  is  chiefly  taught  in  this 
amphitheatre.  General  anatomy,  or  histology,  on  the 
other  hand,  is  almost  all  new ;  it  has  grown  up,  mainly, 
since  I  began  my  medical  studies.  I  never  saw  a  com 
pound  microscope  during  my  years  of  study  in  Paris. 
Individuals  had  begun  to  use  the  instrument,  but  I 
never  heard  it  alluded  to  by  either  Professors  or  stu 
dents.  In  descriptive  anatomy  I  have  found  little  to 
unlearn,  and  not  a  great  deal  that  was  both  new  and 
important  to  learn.  Trifling  additions  are  made  from 
year  to  year,  not  to  be  despised  and  not  to  be  over 
valued.  Some  of  the  older  anatomical  works  are  still 
admirable,  some  of  the  newer  ones  very  much  the  con 
trary.  I  have  had  recent  anatomical  plates  brought 
me  for  inspection,  and  I  have  actually  button-holed  the 
book-agent,  a  being  commonly  as  hard  to  get  rid  of  as 
the  tar-baby  in  the  negro  legend,  that  I  might  put  him 
to  shame  with  the  imperial  illustrations  of  the  bones 


SOME  OF  MT  EARLY  TEACHERS.       423 

and  muscles  In  the  great  folio  of  Albinus,  published  in 
1747,  and  the  unapproached  figures  of  the  lymphatic 
system  of  Mascagni,  now  within  a  very  few  years  of  a 
century  old,  and  still  copied,  or,  rather,  pretended  to 
be  copied,  in  the  most  recent  works  on  anatomy. 

I  am  afraid  that  it  is  a  good  plan  to  get  rid  of  old 
Professors,  and  I  am  thankful  to  hear  that  there  is  a 
movement  for  making  provision  for  those  who  are  left 
in  need  when  they  lose  their  oflices  and  their  salaries. 
I  remember  one  of  our  ancient  Cambridge  Doctors 
once  asked  me  to  get  into  his  rickety  chaise,  and  said 
to  me,  half  humorously,  half  sadly,  that  he  was  like  an 
old  horse,  —  they  had  taken  off  his  saddle  and  turned 
him  out  to  pasture.  I  fear  the  grass  was  pretty  short 
where  that  old  servant  of  the  public  found  himself 
grazing.  If  I  myself  needed  an  apology  for  holding 
my  office  so  long,  I  should  find  it  in  the  fact  that 
human  anatomy  is  much  the  same  study  that  it  was  in 
the  days  of  Vesalius  and  Fallopius,  and  that  the 
greater  part  of  my  teaching  was  of  such  a  nature  that 
it  could  never  become  antiquated. 

Let  me  begin  with  my  first  experience  as  a  medical 
student.  I  had  come  from  the  lessons  of  Judge  Story 
and  Mr.  Ashmun  in  the  Law  School  at  Cambridge.  I 
had  been  busy,  more  or  less,  with  the  pages  of  Black- 
stone  and  Chitty,  and  other  text-books  of  the  first  year 
of  legal  study.  More  or  less,  I  say,  but  I  am  afraid 
it  was  less  rather  than  more.  For  during  that  year  I 
first  tasted  the  intoxicating  pleasure  of  authorship.  A 
college  periodical,  conducted  by  friends  of  mine,  still 
undergraduates,  tempted  me  into  print,  and  there  is 
no  form  of  lead-poisoning  which  more  rapidly  and 
thoroughly  pervades  the  blood  and  bones  and  marrow 
than  that  which  reaches  the  young  author  through 


MEDICAL   ESSAYS. 

mental  contact  with  type-metal.  Qui  a  &w,  boira,  — • 
he  who  has  once  been  a  drinker  will  drink  again,  says 
the  French  proverb.  So  the  man  or  woman  who  has 
tasted  type  is  sure  to  return  to  his  old  indulgence 
sooner  or  later.  In  that  fatal  year  I  had  my  first  at 
tack  of  authors'  lead-poisoning,  and  I  have  never  got 
quite  rid  of  it  from  that  day  to  this.  But  for  that  I 
might  have  applied  myself  more  diligently  to  my  legal 
studies,  and  carried  a  green  bag  in  place  of  a  stetho 
scope  and  a  thermometer  up  to  the  present  day. 

What  determined  me  to  give  up  Law  and  apply  my 
self  to  Medicine  I  can  hardly  say,  but  I  had  from  the 
first  looked  upon  that  year's  study  as  an  experiment. 
At  any  rate,  I  made  the  change,  and  soon  found  my 
self  introduced  to  new  scenes  and  new  companionships. 

I  can  scarcely  credit  my  memory  when  I  recall  the 
first  impressions  produced  upon  me  by  sights  after 
wards  become  so  familiar  that  they  could  no  more  dis 
turb  a  pulse-beat  than  the  commonest  of  every-day  ex 
periences.  The  skeleton,  hung  aloft  like  a  gibbeted 
criminal,  looked  grimly  at  me  as  I  entered  the  room 
devoted  to  the  students  of  the  school  I  had  joined,  just 
as  the  fleshless  figure  of  Time,  with  the  hour-glass  and 
scythe,  used  to  glare  upon  me  in  my  childhood  from 
the  "  New  England  Primer."  The  white  faces  in  the 
beds  at  the  Hospital  found  their  reflection  in  my  own 
cheeks,  which  lost  their  color  as  I  looked  upon  them. 
All  this  had  to  pass  away  in  a  little  time ;  I  had  chosen 
my  profession,  and  must  meet  its  painful  and  repulsive 
aspects  until  they  lost  their  power  over  my  sensibili* 
ties. 

The  private  medical  school  which  I  had  joined  was 
one  established  by  Dr.  James  Jackson,  Dr.  Walter 
Channing,  Dr.  John  Ware,  Dr.  Winslow  Lewis,  and 


SOME   OF   MY   EARLY  TEACHERS. 

Dr.  George  W.  Otis.  Of  the  first  three  gentlemen  I 
have  either  spoken  elsewhere  or  may  find  occasion  to 
speak  hereafter.  The  two  younger  members  of  this 
association  of  teachers  were  both  graduates  of  our 
University,  one  of  the  year  1819,  the  other  of  1818. 

Dr.  Lewis  was  a  great  favorite  with  students.  He 
was  a  man  of  very  lively  temperament,  fond  of  old 
books  and  young  people,  open-hearted,  free-spoken,  an 
enthusiast  in  teaching,  and  especially  at  home  in  that 
apartment  of  the  temple  of  science  where  nature  is 
seen  in  undress,  the  anthropotomic  laboratory,  known 
to  common  speech  as  the  dissecting-room.  He  had 
that  quality  which  is  the  special  gift  of  the  man  born 
for  a  teacher,  —  the  power  of  exciting  an  interest  in 
that  which  he  taught.  While  he  was  present  the 
apartment  I  speak  of  was  the  sunniest  of  studios  in 
spite  of  its  mortuary  spectacles.  Of  the  students  I 
met  there  I  best  remember  James  Jackson,  Junior, 
full  of  zeal  and  playful  as  a  boy,  a  young  man  whose 
early  death  was  a  calamity  to  the  profession  of  which 
he  promised  to  be  a  chief  ornament ;  the  late  Rev 
erend  J.  S.  C.  Greene,  who,  as  the  prefix  to  his  name 
signifies,  afterwards  changed  his  profession,  but  one  of 
whose  dissections  I  remember  looking  upon  with  admi 
ration  ;  and  my  friend  Mr.  Charles  Amory,  as  we  call 
him,  Dr.  Charles  Amory,  as  he  is  entitled  to  be  called, 
then,  as  now  and  always,  a  favorite  with  all  about  him. 
He  had  come  to  us  from  the  schools  of  Germany,  and 
brought  with  him  recollections  of  the  teachings  of  Blu- 
menbach  and  the  elder  Langenbeck,  father  of  him 
whose  portrait  hangs  in  our  Museum.  Dr.  Lewis  was 
our  companion  as  well  as  our  teacher.  A  good  demon 
strator  is,  —  I  will  not  say  as  important  as  a  good  Pro 
fessor  in  the  teaching  of  Anatomy,  because  I  am  not 


426  MEDICAL  ESSAYS. 

sure  that  he  is  not  more  important.  He  comes  into 
direct  personal  relations  with  the  students,  —  he  is  one 
of  them,  in  fact,  as  the  Professor  cannot  be  from  the 
nature  of  his  duties.  The  Professor's  chair  is  an  insu 
lating  stool,  so  to  speak ;  his  age,  his  knowledge,  real 
or  supposed,  his  official  station,  are  like  the  glass  legs 
which  support  the  electrician's  piece  of  furniture,  and 
cut  it  off  from  the  common  currents  of  the  floor  upon 
which  it  stands.  Dr.  Lewis  enjoyed  teaching  and 
made  his  students  enjoy  being  taught.  He  delighted 
in  those  anatomical  conundrums  to  answer  which  keeps 
the  student's  eyes  open  and  his  wits  awake.  He  was 
happy  as  he  dexterously  performed  the  tour  de  maitre 
of  the  old  barber-surgeons,  or  applied  the  spica  ban 
dage  and  taught  his  scholars  to  do  it,  so  neatly  and 
symmetrically  that  the  aesthetic  missionary  from  the 
older  centre  of  civilization  would  bend  over  it  in  bliss 
ful  contemplation,  as  if  it  were  a  sunflower.  Dr. 
Lewis  had  many  other  tastes,  and  was  a  favorite,  not 
only  with  students,  but  in  a  wide  circle,  professional, 
antiquarian,  masonic,  and  social. 

Dr.  Otis  was  less  widely  known,  but  was  a  fluent 
and  agreeable  lecturer,  and  esteemed  as  a  good  sur 
geon. 

I  must  content  myself  with  this  glimpse  at  myself 
and  a  few  of  my  fellow-students  in  Boston.  After  at 
tending  two  courses  of  Lectures  in  the  school  of  the 
University,  I  went  to  Europe  to  continue  my  studies. 

You  may  like  to  hear  something  of  the  famous  Pro 
fessors  of  Paris  in  the  days  when  I  was  a  student  in 
the  Ecole  de  Mddecine,  and  following  the  great  Hos 
pital  teachers. 

I  can  hardly  believe  my  own  memory  when  I  recall 
the  old  practitioners  and  Professors  who  were  still 


SOME  OF  MY  EARLY  TEACHERS.  427 

going  round  the  hospitals  when  I  mingled  with  the 
train  of  students  that  attended  the  morning  visits. 
See  that  bent  old  man  who  is  groping  his  way  through 
the  wards  of  La  Charite".  That  is  the  famous  Baron 
Boyer,  author  of  the  great  work  on  surgery  in  nine 
volumes,  a  writer  whose  clearness  of  style  commends 
his  treatise  to  general  admiration,  and  makes  it  a  kind 
of  classic.  He  slashes  away  at  a  terrible  rate,  they 
say,  when  he  gets  hold  of  the  subject  of  fistula  in  its 
most  frequent  habitat,  —  but  I  never  saw  him  do  more 
than  look  as  if  he  wanted  to  cut  a  good  collop  out  of  a 
patient  he  was  examining.  The  short,  square,  substan 
tial  man  with  iron-gray  hair,  ruddy  face,  and  white 
apron  is  Baron  Larrey,  Napoleon's  favorite  surgeon, 
the  most  honest  man  he  ever  saw,  —  it  is  reputed  that 
he  called  him.  To  go  round  the  H6tel  des  Invalides 
with  Larrey  was  to  live  over  the  campaigns  of  Napo 
leon,  to  look  on  the  sun  of  Austerlitz,  to  hear  the  can 
nons  of  Marengo,  to  struggle  through  the  icy  waters 
of  the  Beresina,  to  shiver  in  the  snows  of  the  Russian 
retreat,  and  to  gaze  through  the  battle  smoke  upon  the 
last  charge  of  the  red  lancers  on  the  redder  field  of 
Waterloo.  Larrey  was  still  strong  and  sturdy  as  I 
saw  him,  and  few  portraits  remain  printed  in  livelier 
colors  on  the  tablet  of  my  memory. 

Leave  the  little  group  of  students  which  gathers 
about  Larrey  beneath  the  gilded  dome  of  the  Invalides 
and  follow  me  to  the  HQtel  Dieu,  where  rules  and 
reigns  the  master-surgeon  of  his  day,  at  least  so  far 
as  Paris  and  France  are  concerned,  —  the  illustrious 
Baron  Dupuytren.  No  man  disputed  his  reign, — • 
some  envied  his  supremacy.  Lisfranc  shrugged  his 
shoulders  as  he  spoke  of  "  ce  grand  homme  de  1'autre 
co^te"  de  la  riviere,"  that  great  man  on  the  other  side  of 


428  MEDICAL  ESSAYS. 

the  river,  but  the  great  man  he  remained,  until  he 
bowed  before  the  mandate  which  none  may  disobey. 
"Three  times,"  said  Bouillaud,  "did  the  apoplectic 
thunderbolt  fall  on  that  robust  brain,"  —  it  yielded  at 
last  as  the  old  bald  cliff  that  is  riven  and  crashes  down 
into  the  valley.  I  saw  him  before  the  first  thunder 
bolt  had  descended :  a  square,  solid  man,  with  a  high 
and  full-domed  head,  oracular  in  his  utterances,  in 
different  to  those  around  him,  sometimes,  it  was  said, 
very  rough  with  them.  He  spoke  in  low,  even  tones, 
with  quiet  fluency,  and  was  listened  to  with  that  hush 
of  rapt  attention  which  I  have  hardly  seen  in  any  cir 
cle  of  listeners  unless  when  such  men  as  ex-President 
John  Quincy  Adams  or  Daniel  Webster  were  the 
speakers.  I  do  not  think  that  Dupuytren  has  left  a 
record  which  explains  his  influence,  but  in  point  of 
fact  he  dominated  those  around  him  in  a  remarkable 
manner.  You  must  have  all  witnessed  something  of 
the  same  kind.  The  personal  presence  of  some  men 
carries  command  with  it,  and  their  accents  silence  the 
crowd  around  them,  when  the  same  words  from  other 
lips  might  fall  comparatively  unheeded. 

As  for  Lisfranc,  I  can  say  little  more  of  him  than 
that  he  was  a  great  drawer  of  blood  and  hewer  of 
members.  I  remember  his  ordering  a  wholesale  bleed 
ing  of  his  patients,  right  and  left,  whatever  might  be 
the  matter  with  them,  one  morning  when  a  phleboto 
mizing  fit  was  on  him.  I  recollect  his  regretting  the 
splendid  guardsmen  of  the  old  Empire,  —  for  what  ? 
because  they  had  such  magnificent  thighs  to  amputate. 
I  got  along  about  as  far  as  that  with  him,  when  I 
ceased  to  be  a  follower  of  M.  Lisfranc. 

The  name  of  Velpeau  must  have  reached  many  of 
you,  for  he  died  in  1867,  and  his  many  works  made 


SOME  OF  MY  EARLY  TEACHEBS.       429 

his  name  widely  known.  Coming  to  Paris  in  wooden 
shoes,  starving,  almost,  at  first,  he  raised  himself  to 
great  eminence  as  a  surgeon  and  as  an  author,  and  at 
last  obtained  the  Professorship  to  which  his  talents 
and  learning  entitled  him.  His  example  may  be  an 
encouragement  to  some  of  my  younger  hearers  who 
are  born,  not  with  the  silver  spoon  in  their  mouths, 
but  with  the  two-tined  iron  fork  in  their  hands.  It  is 
a  poor  thing  to  take  up  their  milk  porridge  with  in 
their  young  days,  but  in  after  years  it  will  often  trans 
fix  the  solid  dumplings  that  roll  out  of  the  silver 
spoon.  So  Velpeau  found  it.  He  had  not  what  is 
called  genius,  he  was  far  from  prepossessing  in  aspect, 
looking  as  if  he  might  have  wielded  the  sledge-hammer 
(as  I  think  he  had  done  in  early  life)  rather  than  the 
lancet,  but  he  had  industry,  determination,  intelli 
gence,  character,  and  he  made  his  way  to  distinction 
and  prosperity,  as  some  of  you  sitting  on  these  benches 
and  wondering  anxiously  what  is  to  become  of  you  in 
the  struggle  for  life  will  have  done  before  the  twen 
tieth  century  has  got  halfway  through  its  first  quarter. 
A  good  sound  head  over  a  pair  of  wooden  shoes  is  a 
great  deal  better  than  a  wooden  head  belonging  to  an 
owner  who  cases  his  feet  in  calf-skin,  but  a  good  brain 
is  not  enough  without  a  stout  heart  to  fill  the  four 
great  conduits  which  carry  at  once  fuel  and  fire  to  that 
mightiest  of  engines. 

How  many  of  you  who  are  before  me  are  familiarly 
acquainted  with  the  name  of  Broussais,  or  even  with 
that  of  Andral  ?  Both  were  lecturing  at  the  Ecole  de 
Me"decme,  and  I  often  heard  them.  Broussais  was  in 
those  days  like  an  old  volcano,  which  has  pretty  nearly 
used  up  its  fire  and  brimstone,  but  is  still  boiling  and 
bubbling  in  its  interior,  and  now  and  then  sends  up  a 


430  MEDICAL  ESSAYS. 

spirt  of  lava  and  a  volley  of  pebbles.  His  theories  of 
gastro-enteritis,  of  irritation  and  inflammation  as  the 
cause  of  disease,  and  the  practice  which  sprang  from 
them,  ran  over  the  fields  of  medicine  for  a  time  like 
flame  over  the  grass  of  the  prairies.  The  way  in  which 
that  knotty-featured,  savage  old  man  would  bring  out 
the  word  irritation  —  with  rattling  and  rolling  redu 
plication  of  the  resonant  letter  r  —  might  have  taught 
a  lesson  in  articulation  to  Salvini.  But  Broussais's 
theory  was  languishing  and  well-nigh  become  obsolete, 
and  this,  no  doubt,  added  vehemence  to  his  defence  of 
his  cherished  dogmas. 

Old  theories,  and  old  men  who  cling  to  them,  must 
take  themselves  out  of  the  way  as  the  new  generation 
with  its  fresh  thoughts  and  altered  habits  of  mind  comes 
forward  to  take  the  place  of  that  which  is  dying  out. 
This  was  a  truth  which  the  fiery  old  theorist  found  it 
very  hard  to  learn,  and  harder  to  bear,  as  it  was  forced 
upon  him.  For  the  hour  of  his  lecture  was  succeeded 
by  that  of  a  younger  and  far  more  popular  professor. 
As  his  lecture  drew  towards  its  close,  the  benches, 
thinly  sprinkled  with  students,  began  to  fill  up ;  the 
doors  creaked  open  and  banged  back  oftener  and  oft- 
ener,  until  at  last  the  sound  grew  almost  continuous, 
and  the  voice  of  the  lecturer  became  a  leonine  growl  as 
he  strove  in  vain  to  be  heard  over  the  noise  of  doors 
and  footsteps. 

Broussais  was  now  sixty-two  years  old.  The  new 
generation  had  outgrown  his  doctrines,  and  the  Pro 
fessor  for  whose  hour  the  benches  had  filled  themselves 
belonged  to  that  new  generation.  Gabriel  Andral  was 
little  more  than  half  the  age  of  Broussais,  in  the  full 
prime  and  vigor  of  manhood  at  thirty-seven  years. 
He  was  a  rapid,  fluent,  fervid,  and  imaginative  speaker, 


SOME  OF  MY  EARLY  TEACHERS.       431 

pleasing  in  aspect  and  manner,  —  a  strong  contrast  to 
the  harsh,  vituperative  old  man  who  had  just  preceded 
him.  His  Clinique  Me'dicale  is  still  valuable  as  a  col 
lection  of  cases,  and  his  researches  on  the  blood,  con 
ducted  in  association  with  Gavarret,  contributed  new 
and  valuable  facts  to  science.  But  I  remember  him 
chiefly  as  one  of  those  instructors  whose  natural  elo 
quence  made  it  delightful  to  listen  to  him.  I  doubt  if 
I  or  my  fellow-students  did  full  justice  either  to  him 
or  to  the  famous  physician  of  H6tel  Dieu,  Chomel. 
We  had  addicted  ourselves  almost  too  closely  to  the 
words  of  another  master,  by  whom  we  were  ready  to 
swear  as  against  all  teachers  that  ever  were  or  ever 
would  be. 

This  object  of  our  reverence,  I  might  almost  say 
idolatry,  was  one  whose  name  is  well  known  to  most 
of  the  young  men  before  me,  even  to  those  who  may 
know  comparatively  little  of  his  works  and  teachings. 
Pierre  Charles  Alexandre  Louis,  at  the  age  of  forty- 
seven,  as  I  recall  him,  was  a  tall,  rather  spare,  digni 
fied  personage,  of  serene  and  grave  aspect,  but  with  a 
pleasant  smile  and  kindly  voice  for  the  student  with 
whom  he  came  into  personal  relations.  If  I  summed 
up  the  lessons  of  Louis  in  two  expressions,  they  would 
be  these ;  I  do  not  hold  him  answerable  for  the  words, 
but  I  will  condense  them  after  my  own  fashion  in 
French,  and  then  give  them  to  you,  expanded  some 
what,  in  English :  — 

Formez  toujours  des  id&s  nettes. 
Fuyez  toujours  les  a  peu  prks. 

Always  make  sure  that  you  form  a  distinct  and  clear 
dea  of  the  matter  you  are  considering. 
Always  avoid  vague  approximations  where  exact  es« 


432  MEDICAL  ESSAYS. 

timates  are  possible ;  about  so  many,  —  about 
instead  of  the  precise  number  and  quantity. 

Now,  if  there  is  anything  on  which  the  biological 
sciences  have  prided  themselves  in  these  latter  years 
it  is  the  substitution  of  quantitative  for  qualitative  for 
mulae.  The  "  numerical  system,"  of  which  Louis  was 
the  great  advocate,  if  not  the  absolute  originator,  was  an 
attempt  to  substitute  series  of  carefully  recorded  facts, 
rigidly  counted  and  closely  compared,  for  those  never- 
ending  records  of  vague,  unverifiable  conclusions  with 
which  the  classics  of  the  healing  art  were  overloaded. 
The  history  of  practical  medicine  had  been  like  the 
story  of  the  Danaides.  "  Experience  "  had  been,  from 
time  immemorial,  pouring  its  flowing  treasures  into 
buckets  full  of  holes.  At  the  existing  rate  of  supply 
and  leakage  they  would  never  be  filled ;  nothing  would 
ever  be  settled  in  medicine.  But  cases  thoroughly  re 
corded  and  mathematically  analyzed  would  always  be 
available  for  future  use,  and  when  accumulated  in  suf 
ficient  number  would  lead  to  results  which  would  be 
trustworthy,  and  belong  to  science. 

You  young  men  who  are  following  the  hospitals 
hardly  know  how  much  you  are  indebted  to  Louis.  I 
say  nothing  of  his  Researches  on  Phthisis  or  his  great 
work  on  Typhoid  Fever.  But  I  consider  his  modest 
and  brief  Essay  on  Bleeding  in  some  Inflammatory 
Diseases,  based  on  cases  carefully  observed  and  nu 
merically  analyzed,  one  of  the  most  important  written 
contributions  to  practical  medicine,  to  the  treatment  of 
internal  disease,  of  this  century,  if  not  since  the  days 
of  Sydenham.  The  lancet  was  the  magician's  wand  of 
the  dark  ages  of  medicine.  The  old  physicians  not  only 
believed  in  its  general  efficacy  as  a  wonder-worker  in 
disease,  but  they  believed  that  each  malady  could  be 


SOME  OF  MY  EARLY  TEACHERS.       433 

successfully  attacked  from  some  special  part  of  the 
body,  —  the  strategic  point  which  commanded  the  seat 
of  the  morbid  affection.  On  a  figure  given  in  the 
curious  old  work  of  John  de  Ketam,  no  less  than 
thirty-eight  separate  places  are  marked  as  the  proper 
ones  to  bleed  from,  in  different  diseases.  Even  Louis, 
who  had  not  wholly  given  up  venesection,  used  now  and 
then  to  order  that  a  patient  suffering  from  headache 
should  be  bled  in  the  foot,  in  preference  to  any  other 
part. 

But  what  Louis  did  was  this :  he  showed  by  a  strict 
analysis  of  numerous  cases  that  bleeding  did  not  stran 
gle, — jugulate  was  the  word  then  used,  —  acute  dis 
eases,  more  especially  pneumonia.  This  was  not  a  re 
form, —  it  was  a  revolution.  It  was  followed  up  in 
this  country  by  the  remarkable  Discourse  of  Dr.  Jacob 
Bigelow  upon  Self-Limited  Diseases,  which  has,  I  be 
lieve,  done  more  than  any  other  work  or  essay  in  our 
own  language  to  rescue  the  practice  of  medicine  from 
the  slavery  to  the  drugging  system  which  was  a  part 
of  the  inheritance  of  the  profession. 

Yes,  I  say,  as  I  look  back  on  the  long  hours  of  the 
many  days  I  spent  in  the  wards  and  in  the  autopsy 
room  of  La  Pitie",  where  Louis  was  one  of  the  attend 
ing  physicians,  —  yes,  Louis  did  a  great  work  for  prac 
tical  medicine.  Modest  in  the  presence  of  nature, 
fearless  in  the  face  of  authority,  unwearying  in  the  pur 
suit  of  truth,  he  was  a  man  whom  any  student  might 
be  happy  and  proud  to  claim  as  his  teacher  and  his 
friend,  and  yet,  as  I  look  back  on  the  days  when  I  fol 
lowed  his  teachings,  I  feel  that  I  gave  myself  up  too 
exclusively  to  his  methods  of  thought  and  study. 

There  is  one  part  of  their  business  which  certain 
medical  practitioners  are  too  apt  to  forget;  namely, 


434  MEDICAL  ESSAYS. 

that  what  they  should  most  of  all  try  to  do  is  to  ward 
off  disease,  to  alleviate  suffering,  to  preserve  life,  or  at 
least  to  prolong  it  if  possible.  It  is  not  of  the  slight 
est  interest  to  the  patient  to  know  whether  three  or 
three  and  a  quarter  cubic  inches  of  his  lung  are  hepa- 
tized.  His  mind  is  not  occupied  with  thinking  of  the 
curious  problems  which  are  to  be  solved  by  his  own 
autopsy,  —  whether  this  or  that  strand  of  the  spinal 
marrow  is  the  seat  of  this  or  that  form  of  degenera 
tion.  He  wants  something  to  relieve  his  pain,  to  miti 
gate  the  anguish  of  dyspnoea,  to  bring  back  motion 
and  sensibility  to  the  dead  limb,  to  still  the  tortures  of 
neuralgia.  What  is  it  to  him  that  you  can  localize 
and  name  by  some  uncouth  term  the  disease  which  you 
could  not  prevent  and  which  you  cannot  cure  ?  An  old 
woman  who  knows  how  to  make  a  poultice  and  how  to 
put  it  on,  and  does  it  tuto,  cito,  jucunde,  just  when 
and  where  it  is  wanted,  is  better,  —  a  thousand  times 
better  in  many  cases,  —  than  a  staring  pathologist,  who 
explores  and  thumps  and  doubts  and  guesses,  and  tells 
his  patient  he  will  be  better  to-morrow,  and  so  goes 
home  to  tumble  his  books  over  and  make  out  a  diag 
nosis. 

But  in  those  days,  I,  like  most  of  my  fellow  students, 
was  thinking  much  more  of  "  science  "  than  of  prac 
tical  medicine,  and  I  believe  if  we  had  not  clung  so 
closely  to  the  skirts  of  Louis  and  had  followed  some 
of  the  courses  of  men  like  Trousseau,  —  therapeutists, 
who  gave  special  attention  to  curative  methods,  and 
not  chiefly  to  diagnosis,  —  it  would  have  been  better 
for  me  and  others.  One  thing,  at  any  rate,  we  did 
learn  in  the  wards  of  Louis.  We  learned  that  a  very 
large  proportion  of  diseases  get  well  of  themselves, 
without  any  special  medication,  —  the  great  fact  for* 


SOME  OF  MY  EARLY  TEACHERS.       435 

mulated,  enforced,  and  popularized  by  Dr.  Jacob  Big1- 
elow  in  the  Discourse  referred  to.  We  wnlearned  the 
habit  of  drugging  for  its  own  sake.  This  detestable 
practice,  which  I  was  almost  proscribed  for  condemn 
ing  somewhat  too  epigrammatically  a  little  more  than 
twenty  years  ago,  came  to  us,  I  suspect,  in  a  consider 
able  measure  from  the  English  "  general  practition 
ers,"  a  sort  of  prescribing  apothecaries.  You  remem 
ber  how,  when  the  city  was  besieged,  each  artisan  who 
was  called  upon  in  council  to  suggest  the  best  means 
of  defence  recommended  the  articles  he  dealt  in :  the 
carpenter,  wood;  the  blacksmith,  iron;  the  mason, 
brick ;  until  it  came  to  be  a  puzzle  to  know  which  to 
adopt. 

"  Then  the  shoemaker  said,  Hang  your  walls  with  new  boots" 

and  gave  good  reasons  why  these  should  be  the  best  of 
all  possible  defences.  Now  the  "  general  practitioner  " 
charged,  as  I  understand,  for  his  medicine,  and  in  that 
way  got  paid  for  his  visit.  Wherever  this  is  the  prac 
tice,  medicine  is  sure  to  become  a  trade,  and  the  people 
learn  to  expect  drugging,  and  to  consider  it  necessary, 
because  drugs  are  so  universally  given  to  the  patients 
of  the  man  who  gets  his  living  by  them. 

It  was  something  to  have  unlearned  the  pernicious 
habit  of  constantly  giving  poisons  to  a  patient,  as  if 
they  were  good  in  themselves,  of  drawing  off  the  blood 
which  he  would  want  in  his  struggle  with  disease,  of 
making  him  sore  and  wretched  with  needless  blisters, 
of  turning  his  stomach  with  unnecessary  nauseous 
draughts  and  mixtures,  —  only  because  he  was  sick 
and  something  must  be  done.  But  there  were  positive 
as  well  as  negative  facts  to  be  learned,  and  some  of 
us,  I  fear,  came  home  rich  in  the  negatives  of  the  ex- 


436  MEDICAL  ESSAY6. 

pectant  practice,  poor  in  the  resources  which  many  a 
plain  country  practitioner  had  ready  in  abundance  for 
the  relief  and  the  cure  of  disease.  No  one  instructor 
can  be  expected  to  do  all  for  a  student  which  he  re 
quires.  Louis  taught  us  who  followed  him  the  love  of 
truth,  the  habit  of  passionless  listening  to  the  teach 
ings  of  nature,  the  most  careful  and  searching  methods 
of  observation,  and  the  sure  means  of  getting  at  the 
results  to  be  obtained  from  them  in  the  constant  em 
ployment  of  accurate  tabulation.  He  was  not  a  showy, 
or  eloquent,  or,  I  should  say,  a  very  generally  popular 
man,  though  the  favorite,  almost  the  idol,  of  many  stu 
dents,  especially  Genevese  and  Bostonians.  But  he 
was  a  man  of  lofty  and  admirable  scientific  character, 
and  his  work  will  endure  in  its  influences  long  after 
his  name  is  lost  sight  of  save  to  the  faded  eyes  of  the 
student  of  medical  literature. 

Many  other  names  of  men  more  or  less  famous  in 
their  day,  and  who  were  teaching  while  I  was  in  Paris, 
come  up  before  me.  They  are  but  empty  sounds  for 
the  most  part  in  the  ears  of  persons  of  not  more  than 
middle  age.  Who  of  you  knows  anything  of  Eiche- 
rand,  author  of  a  very  popular  work  on  Physiology, 
commonly  put  into  the  student's  hands  when  I  first 
began  to  ask  for  medical  text-books?  I  heard  him 
lecture  once,  and  have  had  his  image  with  me  ever 
since  as  that  of  an  old,  worn-out  man,  —  a  venerable 
but  dilapidated  relic  of  an  effete  antiquity.  To  verify 
this  impression  I  have  just  looked  out  the  dates  of  his 
birth  and  death,  and  find  that  he  was  eighteen  years 
younger  than  the  speaker  who  is  now  addressing  you. 
There  is  a  terrible  parallax  between  the  period  before 
thirty  and  that  after  threescore  and  ten,  as  two  men  of 
those  ages  look,  one  with  naked  eyes,  one  through  hia 


SOME  OF  MY  EARLY  TEACHERS.       437 

spectacles,  at  the  man  of  fifty  and  thereabout.  Ma- 
gendie,  I  doubt  not  you  have  all  heard  of.  I  attended 
but  one  of  his  lectures.  I  question  if  one  here,  unless 
some  contemporary  of  my  own  has  strayed  into  the 
amphitheatre,  —  knows  anything  about  Marjolin.  I 
remember  two  things  about  his  lectures  on  surgery,  — 
the  deep  tones  of  his  voice  as  he  referred  to  his  oracle, 
—  the  earlier  writer,  Jean  Louis  Petit,  —  and  his  for 
midable  snuff-box.  What  he  taught  me  lies  far  down, 
I  doubt  not,  among  the  roots  of  my  knowledge,  but 
it  does  not  flower  out  in  any  noticeable  blossoms,  or 
offer  me  any  very  obvious  fruits.  Where  now  is  the 
fame  of  Bouillaud,  Professor  and  Deputy,  the  San- 
grado  of  his  time  ?  Where  is  the  renown  of  Piorry, 
percussionist  and  poet,  expert  alike  in  the  resonances 
of  the  thoracic  cavity  and  those  of  the  rhyming  vocab 
ulary  ?  I  think  life  has  not  yet  done  with  the  viva 
cious  Bicord,  whom  I  remember  calling  the  Voltaire 
of  pelvic  literature,  —  a  sceptic  as  to  the  morality  of 
the  race  in  general,  who  would  have  submitted  Diana 
to  treatment  with  his  mineral  specifics,  and  ordered  a 
course  of  blue  pills  for  the  vestal  virgins. 

Bicord  was  born  at  the  beginning  of  the  century, 
and  Piorry  some  years  earlier.  Cruveilhier,  who  died 
in  1874,  is  still  remembered  by  his  great  work  on  path 
ological  anatomy ;  his  work  on  descriptive  anatomy  has 
some  things  which  I  look  in  vain  for  elsewhere.  But 
where  is  Civiale,  —  where  are  Orfila,  Gendrin,  Rostan, 
Biett,  Alibert,  —  jolly  old  Baron  Alibert,  whom  I  re 
member  so  well  in  his  broad-brimmed  hat,  worn  a  lit 
tle  jauntily  on  one  side,  calling  out  to  the  students  in 
the  court-yard  of  the  Hospital  St.  Louis,  "  Enfans  de 
la  me'thode  naturelle,  6tes-vous  tous  ici  ?  "  "  Children 
of  the  natural  method  [his  own  method  of  classifies^ 


438  MEDICAL   ESSAYS. 

tion  of  skin  diseases],  are  you  all  here  ?  "     All  here, 
then,  perhaps  ;  all  where,  now  ? 

My  show  of  ghosts  is  over.  It  is  always  the  same 
story  that  old  men  tell  to  younger  ones,  some  few  of 
whom  will  in  their  turn  repeat  the  tale,  only  with  al 
tered  names,  to  their  children's  children. 

Like  phantoms  painted  on  the  magic  slide, 
Forth  from  the  darkness  of  the  past  we  glide, 
As  living  shadows  for  a  moment  seen 
In  airy  pageant  on  the  eternal  screen, 
Traced  by  a  ray  from  one  unchanging  flame, 
Then  seek  the  dust  and  stillness  whence  we  came. 

Dr.  Benjamin  Waterhouse,  whom  I  well  remember, 
came  back  from  Leyden,  where  he  had  written  his 
Latin  graduating  thesis,  talking  of  the  learned  Gau- 
bius  and  the  late  illustrious  Boerhaave  and  other  dead 
Dutchmen,  of  whom  you  know  as  much,  most  of  you, 
as  you  do  of  Noah's  apothecary  and  the  family  phy 
sician  of  Methuselah,  whose  prescriptions  seem  to  have 
been  lost  to  posterity.  Dr.  Lloyd  came  back  to  Boston 
full  of  the  teachings  of  Cheselden  and  Sharpe,  Wil 
liam  Hunter,  Smellie,  and  Warner ;  Dr.  James  Jack 
son  loved  to  tell  of  Mr.  Cline  and  to  talk  of  Mr.  John 
Hunter ;  Dr.  Reynolds  would  give  you  his  recollections 
of  Sir  Astley  Cooper  and  Mr.  Abernethy;  I  have 
named  the  famous  Frenchmen  of  my  student  days; 
Leyden,  Edinburgh,  London,  Paris,  were  each  in  turn 
the  Mecca  of  medical  students,  just  as  at  the  present 
day  Vienna  and  Berlin  are  the  centres  where  our 
young  men  crowd  for  instruction.  These  also  must 
sooner  or  later  yield  their  precedence  and  pass  the 
torch  they  hold  to  other  hands.  Where  shall  it  next 
flame  at  the  head  of  the  long  procession  ?  Shall  it 
find  its  old  place  on  the  shores  of  the  Gulf  of  Salerno, 


SOME  OF  MT  EARLY  TEACHERS.       439 

or  shall  it  mingle  its  rays  with  the  northern  aurora  up 
among  the  fiords  of  Norway,  —  or  shall  it  be  borne 
across  the  Atlantic  and  reach  the  banks  of  the  Charles, 
where  Agassiz  and  Wyman  have  taught,  where  Hagen 
still  teaches,  glowing  like  his  own  Lampyris  splendi- 
dula,  with  enthusiasm,  where  the  first  of  American 
botanists  and  the  ablest  of  American  surgeons  are  still 
counted  in  the  roll  of  honor  of  our  great  University ':' 

Let  me  add  a  few  words  which  shall  not  be  other 
than  cheerful,  as  I  bid  farewell  to  this  edifice  which  I 
have  known  so  long.  I  am  grateful  to  the  roof  which 
has  sheltered  me,  to  the  floors  which  have  sustained 
me,  though  I  have  thought  it  safest  always  to  abstain 
from  anything  like  eloquence,  lest  a  burst  of  too  em 
phatic  applause  might  land  my  class  and  myself  in  the 
cellar  of  the  collapsing  structure,  and  bury  us  in  the 
fate  of  Korah,  Dathan,  and  Abiram.  I  have  helped 
to  wear  these  stairs  into  hollows,  —  stairs  which  I  trod 
when  they  were  smooth  and  level,  fresh  from  the  plane. 
There  are  just  thirty-two  of  them,  as  there  were  five 
and  thirty  years  ago,  but  they  are  steeper  and  harder 
to  slimb,  it  seems  to  me,  than  they  were  then.  I  re 
member  that  in  the  early  youth  of  this  building,  the 
late  Dr.  John  K.  Mitchell,  father  of  our  famous  Dr. 
Weir  Mitchell,  said  to  me  as  we  came  out  of  the  Dem 
onstrator's  room,  that  some  day  or  other  a  whole  class 
would  go  heels  over  head  down  this  graded  precipice, 
like  the  herd  told  of  in  Scripture  story.  This  has 
never  happened  as  yet  ,*  I  trust  it  never  will.  I  have 
never  been  proud  of  the  apartment  beneath  the  seats, 
in  which  my  preparations  for  lecture  were  made.  But 
I  chose  it  because  I  could  have  it  to  myself,  and  I 
resign  it,  with  a  wish  that  it  were  more  worthy  of  re 
gret,  into  the  hands  of  my  successor,  with  my  parting 


440  MEDICAL  ESSAYS. 

benediction.  Within  its  twilight  precincts  I  have  often 
prayed  for  light,  like  Ajax,  for  the  daylight  found 
scanty  entrance,  and  the  gaslight  never  illuminated  its 
dark  recesses.  May  it  prove  to  him  who  comes  after 
me  like  the  cave  of  the  Sibyl,  out  of  the  gloomy  depths 
of  which  came  the  oracles  which  shone  with  the  rays 
of  truth  and  wisdom  ! 

This  temple  of  learning  is  not  surrounded  by  the 
mansions  of  the  great  and  the  wealthy.  No  stately 
avenues  lead  up  to  its  fa9ades  and  porticoes.  I  have 
sometimes  felt,  when  convoying  a  distinguished  stran 
ger  through  its  precincts  to  its  door,  that  he  might 
question  whether  star-eyed  Science  had  not  missed  her 
way  when  she  found  herself  in  this  not  too  attractive 
locality.  I  cannot  regret  that  we  —  you,  I  should  say 
—  are  soon  to  migrate  to  a  more  favored  region,  and 
carry  on  your  work  as  teachers  and  as  learners  in  am 
pler  halls  and  under  far  more  favorable  conditions. 

I  hope  that  I  may  have  the  privilege  of  meeting  you 
there,  possibly  may  be  allowed  to  add  my  words  of 
welcome  to  those  of  my  former  colleagues,  and  in  that 
pleasing  anticipation  I  bid  good-by  to  this  scene  of  my 
long  labors,  and,  for  the  present  at  least,  to  the  friends 
with  whom  I  have  been  associated. 


APPENDIX. 


VOTES  TO  THE  ADDRESS  ON  CURRENTS  AND  COUNTES- 
CURRENTS  IN  MEDICAL  SCIENCE. 

SOME  passages  contained  in  the  original  manuscript  of  the 
Address,  and  omitted  in  the  delivery  on  account  of  its  length, 
are  restored  in  the  text  or  incorporated  with  these  Notes. 

NOTE  A.  —  (p.  188.) 

There  is  good  reason  to  doubt  whether  the  nitrate  of  silver 
has  any  real  efficacy  in  epilepsy.  It  has  seemed  to  cure  many 
cases,  but  epilepsy  is  a  very  uncertain  disease,  and  there  is 
hardly  anything  which  has  not  been  supposed  to  cure  it.  Dr. 
Copland  cites  many  authorities  in  its  favor,  most  especially 
Lombard's  cases.  But  De  la  Berge  and  Monneret  (Comp.  de 
Med.  Paris),  1839,  analyze  these  same  cases,  eleven  in  number, 
and  can  only  draw  the  inference  of  a  very  questionable  value  in 
the  supposed  remedy.  Dr.  James  Jackson  says  that  relief  of 
epilepsy  is  not  to  be  attained  by  any  medicine  with  which  he  is 
acquainted,  but  by  diet.  (Letters  to  a  Young  Physician,  p.  67.) 
Guy  Patin,  Dean  of  the  Faculty  of  Paris,  Professor  at  the  Royal 
College,  Author  of  the  Antimonial  Martyrology,  a  wit  and  a  man 
of  sense  and  learning,  who  died  almost  two  hundred  years  ago, 
had  come  to  the  same  conclusion,  though  the  chemists  of  his 
time  boasted  of  their  remedies.  *'  Did  you  ever  see  a  case  of 
epilepsy  cured  by  nitrate  of  silver?  "  I  said  to  one  of  the  oldest 
and  most  experienced  surgeons  in  this  country.  "  Never,"  was 
bis  instant  reply.  Dr.  Twitchell's  experience  was  very  similar. 
How,  then,  did  nitrate  of  silver  come  to  be  given  for  epilepsy? 
Because,  as  Dr.  Martin  has  so  well  reminded  us,  lunatics  were 
considered  formerly  to  be  under  the  special  influence  of  Luna, 
the  moon  (which  Esquirol,  be  it  observed,  utterly  denies),  and 
lunar  caustic,  or  nitrate  of  silver,  is  a  salt  of  that  metal  which 


442  APPENDIX. 

was  called  luna  from  its  whiteness,  and  of  course  must  be  in  the 
closest  relations  with  the  moon.  It  follows  beyond  all  reason 
able  question  that  the  moon's  metal,  silver,  and  its  preparations, 
must  be  the  specific  remedy  for  moon-blasted  maniacs  and  epi 
leptics  ! 

Yet  the  practitioner  who  prescribes  the  nitrate  of  silver  sup 
poses  he  is  guided  by  the  solemn  experience  of  the  past,  instead 
of  by  its  idle  fancies.  He  laughs  at  those  old  physicians  who 
placed  such  confidence  in  the  right  hind  hoof  of  an  elk  as  a  rem 
edy  for  the  same  disease,  and  leaves  the  record  of  his  own  belief 
in  a  treatment  quite  as  fanciful  and  far  more  objectionable, 
written  in  indelible  ink  upon  a  living  tablet  where  he  who  runs 
may  read  it  for  a  whole  generation,  if  nature  spares  his  walking 
advertisement  so  long. 

NOTE  B.— (p.  201.) 

The  presumption  that  a  man  is  innocent  until  he  is  proved 
guilty,  does  not  mean  that  there  are  no  rogues,  but  lays  the  onus 
probandi  on  the  party  to  which  it  properly  belongs.  So  with 
this  proposition.  A  noxious  agent  should  never  be  employed  in 
sickness  unless  there  is  ample  evidence  in  the  particular  case  to 
overcome  the  general  presumption  against  all  such  agents,  — 
and  the  evidence  is  very  apt  to  be  defective. 

The  miserable  delusion  of  Homoeopathy  builds  itself  upon  an 
axiom  directly  the  opposite  of  this;  namely,  that  the  sick  are  to 
be  cured  by  poisons.  Similia  similibus  curantur  means  exactly 
this.  It  is  simply  a  theory  of  universal  poisoning,  nullified  in 
practice  by  the  infinitesimal  contrivance.  The  only  way  to  kill 
it  and  all  similar  fancies,  and  to  throw  every  quack  nostrum  into 
discredit,  is  to  root  out  completely  the  suckers  of  the  old  rotten 
superstition  that  whatever  is  odious  or  noxious  is  likely  to  be 
good  for  disease.  The  current  of  sound  practice  with  ourselves 
is,  I  believe,  setting  fast  in  the  direction  I  have  indicated  in  the 
above  proposition.  To  uphold  the  exhibition  of  noxious  agents 
in  disease,  as  the  rule,  instead  of  admitting  them  cautiously  and 
reluctantly  as  the  exception,  is,  as  I  think,  an  eddy  of  opinion  in 
the  direction  of  the  barbarism  out  of  which  we  believe  our  art  is 
escaping.  It  is  only  through  the  enlightened  sentiment  and  ac- 
tioa  of  the  Medical  Profession  that  the  community  can  be 
brought  to  acknowledge  that  drugs  should  "  always  be  regarded 
as  evils." 


APPENDIX.  443 

It  is  true  that  some  suppose,  and  our  scientific  and  thoughtful 
associate,  Dr.  Gould,  has  half  countenanced  the  opinion,  that 
there  may  yet  be  discovered  a  specific  for  every  disease.  Let 
us  not  despair  of  the  future,  but  let  us  be  moderate  in  our  ex 
pectations.  When  an  oil  is  discovered  that  will  make  a  bad 
watch  keep  good  time ;  when  a  recipe  is  given  which  will  turn 
an  acephalous  foetus  into  a  promising  child;  when  a  man  can 
enter  the  second  time  into  his  mother's  womb  and  give  her  back 
the  infirmities  which  twenty  generations  have  stirred  into  her 
blood,  and  infused  into  his  own  through  hers,  we  may  be  pre 
pared  to  enlarge  the  National  Pharmacopoeia  with  a  list  of  spe 
cifics  for  everything  but  old  age,  —  and  possibly  for  that  also. 

NOTE  C.  —  (p.  203.) 

The  term  specific  is  used  here  in  its  ordinary  sense,  without 
raising  the  question  of  the  propriety  of  its  application  to  these 
or  other  remedies. 

The  credit  of  introducing  Cinchona  rests  between  the  Jesuits, 
the  Countess  of  Chinchon,  the  Cardinal  de  Lugo,  and  Sir  Robert 
Talbor,  who  employed  it  as  a  secret  remedy.  (Pereira.)  Mer 
cury  as  an  internal  specific  remedy  was  brought  into  use  by  that 
"impudent  and  presumptuous  quack,"  as  he  was  considered, 
Paracelsus.  (Encyc.  Brit.  art.  "  Paracelsus.")  Arsenic  was 
introduced  into  England  as  a  remedy  for  intermittents  by  Dr. 
Fowler,  in  consequence  of  the  success  of  a  patent  medicine,  the 
Tasteless  Ague  Drops,  which  were  supposed,  "  probably  with 
reason,"  to  be  a  preparation  of  that  mineral.  (Rees's  Cyc, 
art.  "  Arsenic.")  Colchicum  came  into  notice  in  a  similar  way, 
from  the  success  of  the  Eau  Medicinale  of  M.  Husson,  a  French 
military  officer.  (Pereira.)  Iodine  was  discovered  by  a  salt 
petre  manufacturer,  but  applied  by  a  physician  in  place  of  the 
old  remedy,  burnt  sponge,  which  seems  to  owe  its  efficacy  to  it. 
(Dunglison,  New  Remedies.)  As  for  Sulphur,  "the  common 
people  have  long  used  it  as  an  ointment"  for  scabies,  (lees's 
Cyc.  art.  "  Scabies.")  The  modern  antiscorbutic  regimen  is 
credited  to  Captain  Cook.  "  To  his  sagacity  we  are  indebted 
for  the  first  impulse  to  those  regulations  by  which  scorbutus  is 
so  successfully  prevented  in  our  navy."  (Lone?.  Cyc.  Prac.  Med. 
art.  "  Scorbutus.")  Iron  and  various  salts  which  enter  into  the 
normal  composition  of  the  human  body  do  not  belong  to  the  ma-* 
teria  medica  by  our  definition,  but  to  the  materia  alimentaria. 


444  APPENDIX. 

For  the  first  introduction  of  iron  as  a  remedy,  see  Pereira,  who 
gives  a  very  curious  old  story. 

The  statement  in  the  text  concerning  a  portion  of  the  materia 
medica  stands  exactly  as  delivered,  and  is  meant  exactly  as  it 
stands.  No  denunciation  of  drugs,  as  sparingly  employed  by  a 
wise  physician,  was  or  is  intended.  If,  however,  as  Dr.  Gould 
stated  in  his  "  valuable  and  practical  discourse  "  to  which  the 
Massachusetts  Medical  Society  "  listened  with  profit  as  well  as 
Interest,"  "  Drugs,  in  themselves  considered,  may  always  be  re 
garded  as  evils,"  — any  one  who  chooses  may  question  whether 
the  evils  from  their  abuse  are,  on  the  whole,  greater  or  less  than 
the  undoubted  benefits  obtained  from  their  proper  use.  The 
large  exception  of  opium,  wine,  specifics,  and  anaesthetics,  made 
in  the  text,  takes  off  enough  from  the  useful  side,  as  I  fully  be 
lieve,  to  turn  the  balance  ;  so  that  a  vessel  containing  none  of 
these,  but  loaded  with  antimony,  strychnine,  acetate  of  lead, 
aloes,  aconite,  lobelia,  lapis  infernalis,  stercus  diaboli,  tormen- 
tilla,  and  other  approved,  and,  in  skilful  hands,  really  useful 
remedies,  brings,  on  the  whole,  more  harm  than  good  to  the 
port  it  enters. 

"  It  is  a  very  narrow  and  unjust  view  of  the  practice  of  medi 
cine,  to  suppose  it  to  consist  altogether  in  the  use  of  powerful 
drugs,  or  of  drugs  of  any  kind.  Far  from  it."  "  The  physician 
may  do  very  much  for  the  welfare  of  the  sick,  more  than  otherg 
can  do,  although  he  does  not,  even  in  the  major  part  of  cases, 
undertake  to  control  and  overcome  the  disease  by  art.  It  was 
with  these  views  that  I  never  reported  any  patient  cured  at  our 
hospital.  Those  who  recovered  their  health  were  reported  as 
well,  not  implying  that  they  were  made  so  by  the  active  treat 
ment  they  had  received  there.  But  it  was  to  be  understood  that 
all  patients  received  in  that  house  were  to  be  cured,  that  is. 
taken  care  of."  (Letters  to  a  Young  Physician,  by  James  Jack 
son,  M.  D.,  Boston,  1855.) 

"  Hygienic  rules,  properly  enforced,  fresh  air,  change  of  air, 
travel,  attention  to  diet,  good  and  appropriate  food  judiciously 
regulated,  together  with  the  administration  of  our  tonics,  porter, 
ale,  wine,  iron,  etc.,  supply  the  diseased  or  impoverished  system 
with  what  Mr.  Gull,  of  St.  Bartholomew's  Hospital,  aptly  calls 
*  the  raw  material  of  the  blood ; '  and  we  believe  that  if  any  real 
improvement  has  taken  place  in  medical  practice,  independently 
of  those  truly  valuable  contributions  we  have  before  describedi 


APPENDIX. 

it  is  in  the  substitution  of  tonics,  stimulants,  and  general  man 
agement,  for  drastic  cathartics,  for  bleeding,  depressing  agents, 
including  mercury,  tartar  emetics,  etc.,  so  much  in  vogue  dur 
ing  the  early  part  even  of  this  century."  (F.  P.  Porcher,  in 
Charleston  Med.  Journal  and  Review  for  January*  I860.} 


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